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R A655  .157  1916       Interstate  quaranti 

.157 
1916 


TREASURY  DEPARTMENT 
UNITED  STATES  PUBLIC  HEALTH  SERVICE 


MISCELLANEOUS  PUBLICATION  No.  1 


INTERSTATE 
QUARANTINE  REGULATIONS 


OF  THE 


UNITED  STATES 


Prepared  by  direction  of  the  Surgeon  General 


"WASHINGTON 
GOVERNMENT  PRINTING  OFFICE 

1916 


COLLEGE  OF 

PHYSICIANS  AND  SURGEONS 

LIBRARY 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/interstatequaranOOunit 


TREASURY  DEPARTMENT 
UNITED  STATES  PUBLIC  HEALTH  SERVICE 


MISCELLANEOUS  PUBLICATION  No.  1 


INTERSTATE 
QUARANTINE  REGULATION! 

OF  THE 

UNITED  STATES 


1916 


Prepared  by  direction  of  the  Surgeon  General 


WASHINGTON 
GOVERNMENT  PRINTING  OFFICE 

1916 


Z9- 

J-J7- 


ADDITIONAL  COPIES 

OF  THIS  PUBLICATION  MAY  BE  PROCURED  FROM 

THE  SUPERINTENDENT  OF  DOCUMENTS 

GOVERNMENT  PRINTING  OFFICE 

WASHINGTON,  D.  C. 

AT 

10  CENTS  PER  COPY 


CONTENTS. 


Quarantine  laws  of  the  "United  States 7 

Act  to  prevent  the  introduction  of  contagious  diseases  from  one  State  to 

another  and  for  the  punishment  of  certain  offenses.    Approved  March  27, 

1890.    (U.  S.  Stats.  A.  L.,  vol.  26,  ch.  51,  p.  31) 7 

Act  granting  additional  quarantine  powers  and  imposing  additional  duties 

upon    the    Marine-Hospital    Service.      Approved    February    15,    1893. 

(IT.  S.  Stats.  A.  L.,  vol.  27,  ch.  114,  p.  449) 7 

Act  to  amend  section  2  of  the  act  approved  February  15,  1893,  entitled 

"An  act  granting  additional  quarantine  powers  and  imposing  additional 

duties  upon  the  Marine-Hospital  Service, "  approved  August  18,  1894. 

(U.  S.  Stats.  A.  L.,  vol.  28,  ch.  300,  p.  372) 10 

Act  to  amend  ' '  An  act  granting  additional  quarantine  powers  and  imposing 

additional  duties  upon  the  Marine-Hospital  Service,  approved  February 

15,  1893."    Approved  March  3,  1901.    (U.  S.  Stats.  A.  L.,  vol.  31,  ch. 

836,  p.  1086.) 11 

Promulgation  of  interstate  quarantine  regulations  by  the  Secretary  of  the 

Treasury,  January  15, 1916 , 13 

Interstate  quarantine  regulations . 15 

Section  1.  Diseases  regarded  as  contagious  or  infectious  diseases  within  the 

meaning  of  the  act  of  February  15,  1893 15 

Section  2.  Interstate  vehicles  to  be  clean 15 

Section  3.  Fumigation  of  forecastles;  act  approved  March  9, 1915 15 

Section  4.  Cleaning  of  interstate  vehicles 15 

Section  5.  Bedding  furnished  for  use  of  interstate  passengers 15 

Section  6.  Ventilation  of  interstate  vehicles 16 

Section  7.  Toilets  and  lavatories  on  interstate  vehicles 16 

Section  8 .  Measures  for  the  prevention  of  spitting  within  interstate  vehicles.        16 

Section  9.  Common  towels  prohibited 16 

Section  10.  Common  drinking  cups  prohibited 16 

Section  11 .  Food  and  drink  for  interstate  passengers 16 

Section  12.  Milk  from  infected  premises  not  to  be  transported 17 

Section  13(a) .  Pure  water  for  interstate  passengers 17 

Section  13(b).  Ice  used  for  cooling  water  furnished  interstate  passengers. ..         17 

Section  13(c).  Cleansing  of  water  containers 17 

Section  14.  Water  for  employees  of  common  carriers — notices  to  be  posted 

over  impure  water  supplies  at  or  near  stations 18 

Section  15.  Water  from  harbors  not  to  be  furnished  to  any  vessel 18 

Section  16.  Vessels  not  to  furnish  water  to  passengers  from  lake  or  stream 

over  which  vessel  is  being  navigated 18 

Section  17.  Common  carriers  not  to  accept  for  interstate  shipment  persons 

suffering  from  communicable  diseases. 19 

Section  18.  Persons  suffering  from  communicable  diseases  not  to  travel  in 

interstate  traffic 19 

Section  19.  Articles  known  to  be  infectious  or  contagious  not  to  be  trans- 
ported          19 

Section  20.  Outgoing  quarantine  measures  to  prevent  the  spread  of  plague . .  19 
Section  21.  Prevention  of  spread  of  disease  from  infected  persons  or  things.        20 

3 


4  CONTENTS. 

Interstate  quarantine  regulations — Continued.  Page. 
Section  22.  Sick  passengers  to  be  removed  at  first  convenient  place — 

Surgeon  General  and  State  and  local  health  authorities  to  be  notified 20 

Section  23.  Certain  infected  persons  who  may  not  travel 20 

Section  24.  Interstate  carriage  of  typhoid  patients 20 

Section  24(a).  Rules  for  nurses  accompanying  typhoid  patients 20 

Section  24(b).  Disinfection  of  compartment  upon  removal   of   typhoid 

patient 21 

Section  25.  Measures  to  be  taken  upon  occurrence  of  case  of  yellow  fever 

en  route 21 

Section  26.  Vessels  or  vehicles  not  to  be  removed  from  yellow  fever  localities 

without  permit 21 

Section  27.  Interstate  carriage  of  diphtheria,  measles,  or  whooping-cough 

patients 22 

Section  27(a).   Rules  for  nurses  accompanying  diphtheria,   measles,   or 

whooping-cough  patients 22 

Section  27(b).  Disinfection  of  compartment  upon  removal  of  case  of  diph- 
theria, measles,  or  whooping  cough 22 

Section  28.  Interstate  carriage  of  tuberculous  persons 22 

Section  28(a).  Articles  with  which  tuberculous  person  shall  be  provided 

while  traveling 23 

Section  28(b)  Disinfection  of  compartment  upon  disembarkation  of  tuber- 
culous person 23 

Section  28(c)  Tuberculous  passengers  not  to  expectorate  except  in  sputum 

cup  or  gauze 23 

Section  29.  Lepers  not  to  be  accepted  for  interstate  transportation  without 

permit 23 

Section  30.  Lepers  not  to  accept  transportation  unless  permits  have  been 

obtained 23 

Section  31.  Lepers  violating  section  30  to  be  returned  to  State  from  which 

they  may  have  departed  or  removed  to  Federal  quarantine  station 24 

Section  32.  Incubation  periods 24 

Section  33.  Notification  of  contagious  or  infectious  diseases 24 

Section  34.  Notification  of  unusual  outbreak  of  disease 24 

Section  35.  Interstate  sanitary  officers  to  enforce  regulations  and  collect 

information 25 

Section  36.  Shipment  of  animals  from  localities  infected  with  Rocky 

Mountain  spotted  fever 25 

Appendix 27-41 

Disinfectants 27 

Classes  of  disinfectants 27 

Physical  disinfectants 27 

Burning 27 

Boiling . 27 

Steam,  flowing,  not  under  pressure 27 

Steam  under  pressure  without  vacuum 27 

Steam  under  pressure  with  vacuum 27 

Gaseous  disinfectants _. 27 

In  general 27 

Formaldehyde 28 

Formalin-permanganate  method 29 

Formalin-sheet-spraying  method 30 

Formalin-aluminum-sulphate-lime  method 30 

Paraform 31 


CONTENTS.  5 

Appendix — Continued. 

Disinfectants — Continued . 

Gaseous  disinfectants — Continued.  Page. 

Sulphur  dioxide 32 

The  pot  method 32 

Liquid  sulphur  dioxide 33 

Sulphur  candles 34 

Chemical  solutions 34 

Bichloride  of  mercury 34 

Formalin,  solution  of  formaldehyde,  U.  S.  P 35 

Carbolic  acid 35 

Crude  carbolic  acid 36 

Tricresol 36 

Lysol  and  creolin 36 

Agents  for  the  destruction  of  vermin 36 

In  general 36 

Sulphur 37 

Sulphur  dioxide 37 

The  pot  method 37 

Liquid  sulphur  dioxide 37 

Sulphur  candles 37 

Hydrocyanic  acid  gas 37 

Pyrethrum 38 

Disinfection  of  compartments - 39 

Disinfection  of  bed  clothes,  towels,  etc 39 

Disinfection  of  textiles  soiled  with'  discharges  of  the  sick  or  presum- 
ably infected 39 

Disinfection  of  cooking  and  eating  utensils 39 

Disinfection  of  living  apartments,  cabins,  and  forecastles  of  vessels. . .  39 

Disinfection  of  mattresses,  pillows,  and  other  heavy  fabrics 40 

Disinfection  of  holds  of  vessels 40 

iacteriological  standard  for  drinking  water 40 

^orm  of  certificate  of  examination  of  water  for  passengers  in  interstate  traffic .  41 
3tructions  relative  to  the  certification  of  water  furnished  to  passengers 

in  interstate  traffic 41 


QUARANTINE  LAWS  OF  THE  UNITED  STATES. 


An  act  to  prevent  the  introduction  of  contagious  diseases  from  one  State  to  another 
and  for  the  punishment  of  certain  offenses. 

(U.  S.  Stats,  at  Large,  vol.  26,  ch.  51,  p.  31.    Approved  Mar.  27, 1890.) 

Be  it  enacted  by  the  Senate  and  House  of  Representatives  of  the  United  States  of  America 
in  Congress  assembled,  That  whenever  it  shall  be  made  to  appear  to  the  satisfaction  of 
the  President  that  cholera,  yellow  fever,  smallpox,  or  plague  exists  in  any  State  or 
Territory,  or  in  the  District  of  Columbia,  and  that  there  is  danger  of  the  spread  of  such 
disease  into  other  States,  Territories,  or  the  District  of  Columbia,  he  is  hereby  author- 
ized to  cause  the  Secretary  of  the  Treasury  to  promulgate  such  rules  and  regulations  as 
in  his  judgment  may  be  necessary  to  prevent  the  spread  of  such  disease  from  one 
State  or  Territory  into  another,  or  from  any  State  or  Territory  into  the  District  of 
Columbia,  or  from  the  District  of  Columbia  into  any  State  or  Territory,  and  to  employ 
such  inspectors  and  other  persons  as  may  be  necessary  to  execute  such  regulations  to 
prevent  the  spread  of  such  disease.  The  said  rules  and  regulations  shall  be  prepared 
by  the  Supervising  Surgeon  General  of  the  Marine-Hospital  Service  under  the  direc- 
tion of  the  Secretary  of  the  Treasury.  And  any  person  who  shall  willfully  violate  any 
rule  or  regulation  so  made  and  promulgated  shall  be  deemed  guilty  of  a  misdemeanor, 
and  upon  conviction  shall  be  punished  by  a  fine  of  not  more  than  five  hundred  dollars, 
or  imprisonment  for  not  more  than  two  years,  or  both,  in  the  discretion  of  the  court. 

Sec.  2.  That  any  officer,  or  person  acting  as  an  officer,  or  agent  of  the  United  States 
at  any  quarantine  station,  or  other  person  employed  to  aid  in  preventing  the  spread  of 
such  disease,  who  shall  willfully  violate  any  of  the  quarantine  laws  of  the  United  States 
or  any  of  the  rules  and  regulations  made  and  promulgated  by  the  Secretary  of  the 
Treasury  as  provided  for  in  section  one  of  this  act,  or  any  lawful  order  of  his  superior 
officer  or  officers,  shall  be  deemed  guilty  of  a  misdemeanor,  and  upon  conviction  shall 
be  punished  by  a  fine  of  not  more  than  three  hundred  dollars  or  imprisonment  for  not 
more  than  one  year,  or  both,  in  the  discretion  of  the  court. 

Sec.  3.  That  when  any  common  carrier  or  officer,  agent,  or  employee  of  any  common 
carrier  shall  willfully  violate  any  of  the  quarantine  laws  of  the  United  States,  or  the 
rules  and  regulations  made  and  promulgated  as  provided  for  in  section  one  of  this  act, 
such  common  carrier,  officer,  agent,  or  employee  shall  be  deemed  guilty  of  a  misde- 
meanor, and  shall,  on  conviction,  be  punished  by  a  fine  of  not  more  than  five  hundred 
dollars,  or  imprisonment  for  not  more  than  two  years,  or  both,  in  the  discretion  of  the 
court. 

An  act  granting  additional  quarantine  powers  and  imposing  additional  duties  upon 
the  Marine-Hospital  Service. 

(U.  S.  Stats,  at  Large,  vol.  27,  ch.  114,  p.  449.    Approved  Feb.  15, 1893.) 

Be  it  enacted  by  the  Senate  and  House  of  Representatives  of  the  United  States  of  America 
in  Congress  assembled,  That  it  shall  be  unlawful  for  any  merchant  ship  or  other  vessel 
from  any  foreign  port  or  place  to  enter  any  port  of  the  United  States  except  in  accord- 
ance with  the  provisions  of  this  act  and  with  such  rules  and  regulations  of  State  and 
municipal  health  authorities  as  may  be  made  in  pursuance  of  or  consistent  with  this 
27165°— 16 -2  7 


8  INTERSTATE    QUARANTINE    REGULATIONS. 

act;  and  any  such  vessel  which  shall  enter,  or  attempt  to  enter,  a  port  of  the  United 
States  in  violation  thereof  shall  forfeit  to  the  United  States  a  sum,  to  be  awarded  in  the 
discretion  of  the  court,  not  exceeding  five  thousand  dollars,  which  shall  be  a  lien  upon 
said  vessel,  to  be  recovered  by  proceedings  in  the  proper  district  court  of  the  United 
States.  In  all  such  proceedings  the  United  States  district  attorney  for  such  district 
shall  appear  on  behalf  of  the  United  States;  and  all  such  proceedings  shall  be  con- 
ducted in  accordance  with  the  rules  and  laws  governing  cases  of  seizure  of  vessels  for 
violation  of  the  revenue  laws  of  the  United  States, 

Sec.  2.  That  any  vessel  at  any  foreign  port  clearing  for  any  port  or  place  in  the  United 
States  shall  be  required  to  obtain  from  the  consul,  vice  consul,  or  other  consular  officer 
of  the  United  States  at  the  port  of  departure,  or  from  the  medical  officer  where  such 
officer  has  been  detailed  by  the  President  for  that  purpose,  a  bill  of  health,  in  duplicate, 
in  the  form  prescribed  by  the  Secretary  of  the  Treasury,  setting  forth  the  sanitary 
history  and  condition  of  said  vessel,  and  that  it  has  in  all  respects  complied  with  the 
rules  and  regulations  in  such  cases  prescribed  for  securing  the  best  sanitary  condition 
of  the  said  vessel,  its  cargo,  passengers,  and  crew;  and  said  consular  or  medical  officer 
is  required,  before  granting  such  duplicate  bill  of  health,  to  be  satisfied  that  the 
matters  and  things  therein  stated  are  true;  and  for  his  services  in  that  behalf  he  shall 
be  entitled  to  demand  and  receive  such  fees  as  shall  by  lawful  regulation  be  allowed, 
to  be  accounted  for  as  is  required  in  other  cases. 

The  President,  in  his  discretion,  is  authorized  to  detail  any  medical  officer  of  the 
Government  to  serve  in  the  office  of  the  consul  at  any  foreign  port  for  the  purpose 
of  furnishing  information  and  making  the  inspection  and  giving  the  bills  of  health 
hereinbefore  mentioned.  Any  vessel  clearing  and  sailing  from  any  such  port  without 
such  bill  of  health,  and  entering  any  port  of  the  United  States,  shall  forfeit  to  the 
United  States  not  more  than  five  thousand  dollars,  the  amount  to  be  determined  by 
the  court,  which  shall  be  a  lien  on  the  same,  to  be  recovered  by  proceedings  in  the 
proper  district  court  of  the  United  States.  In  all  such  proceedings  the  United  States 
district  attorney  for  such  district  shall  appear  on  behalf  of  the  United  States;  and 
all  such  proceedings  shall  be  conducted  in  accordance  with  the  rules  and  laws  govern- 
ing cases  of  seizure  of  vessels  for  violation  of  the  revenue  laws  of  the  United  States. 

Sec.  3.  That  the  Supervising  Surgeon  General  of  the  Marine-Hospital  Service 
shall,  immediately  after  this  act  takes  effect,  examine  the  quarantine  regulations 
of  all  State  and  municipal  boards  of  health,  and  shall,  under  the  direction  of  the 
Secretary  of  the  Treasury,  cooperate  with  and  aid  State  and  municipal  boards  of 
health  in  the  execution  and  enforcement  of  the  rules  and  regulations  of  such  boards 
and  in  the  execution  and  enforcement  qi  the  rules  and  regulations  made  by  the  Secre- 
tary of  the  Treasury  to  prevent  the  introduction  of  contagious  or  infectious  diseases 
into  the  United  States  from  foreign  countries,  and  into  one  State  or  Territory  or  the 
District  of  Columbia  from  another  State  or  Territory  or  the  District  of  Columbia; 
and  all  rules  and  regulations  made  by  the  Secretary  of  the  Treasury  shall  operate  uni- 
formly and  in  no  manner  discriminate  against  any  port  or  place;  and  at  such  ports 
and  places  within  the  United  States  as  have  no  quarantine  regulations  under  State 
or  municipal  authority,  where  such  regulations  are,  in  the  opinion  of  the  Secretary 
of  the  Treasury,  necessary  to  prevent  the  introduction  of  contagious  or  infectious 
diseases  into  the  United  States  from  foreign  countries,  or  into  one  State  or  Territory 
or  the  District  of  Columbia  from  another  State  or  Territory  or  the  District  of  Columbia, 
and  at  such  ports  and  places  within  the  United  States  where  quarantine  regulations 
exist  under  the  authority  of  the  State  or  municipality  which,  in  the  opinion  of  the 
Secretary  of  the  Treasury,  are  not  sufficient  to  prevent  the  introduction  of  such  dis- 
eases into  the  United  States,  or  into  one  State  or  Territory  or  the  District  of  Columbia 
from  another  State  or  Territory  or  the  District  of  Columbia,  the  Secretary  of  the 
Treasury  shall,  if  in  his  judgment  it  is  necessary  and  proper,  make  such  additional 
rules  and  regulations  as  are  necessary  to  prevent  the  introduction  of  such  diseases 


IISTTEKSTATE    QUARANTINE    REGULATIONS.  9 

into  the  United  States  from  foreign  countries,  or  into  one  State  or  Territory  or  the 
District  of  Columbia  from  another  State  or  Territory  or  the  District  of  Columbia,  and 
when  such  rules  and  regulations  have  been  made  they  shall  be  promulgated  by  the 
Secretary  of  the  Treasury,  and  enforced  by  the  sanitary  authorities  of  the  States  and 
municipalities,  where  the.  State  and  municipal  health  authorities  will  undertake  to 
execute  and  enforce  them;  but  if  the  State  or  municipal  authorities  shall  fail  or  refuse 
to  enforce  said  rules  and  regulations  the  President  shall  execute  and  enforce  the 
same  and  adopt  such  measures  as  in  his  judgment  shall  be  necessary  to  prevent  the 
introduction  or  spread  of  such  diseases,  and  may  detail  or  appoint  officers  for  that 
purpose.  The  Secretary  of  the  Treasury  shall  make  such  rules  and  regulations  as 
are  necessary  to  be  observed  by  vessels  at  the  port  of  departure  and  on  the  voyage, 
where  such  vessels  sail  from  any  foreign  port  or  place  to  any  port  or  place  in  the  United 
States,  to  secure  the  best  sanitary  condition  of  such  vessel,  her  cargo,  passengers, 
and  crew,  which  shall  be  published  and  communicated  to  and  enforced  by  the  con- 
sular officers  of  the  United  States.  None  of  the  penalties  herein  imposed  shall  attach 
to  any  vessel  or  owner  or  officer  thereof  until  a  copy  of  this  act,  with  the  rules  and 
regulations  made  in  pursuance  thereof,  has  been  posted  up  in  the  office  of  the  consul 
or  other  consular  officer  of  the  United  States  for  ten  days  in  the  port  from  which  said 
vessel  sailed ;  and  the  certificate  of  such  consul  or  consular  officer  over  his  official 
signature  shall  be  competent  evidence  of  such  posting  in  any  court  of  the  United 
States. 

Sec.  4.  That  it  shall  be  the  duty  of  the  Supervising  Surgeon  General  of  the  Marine 
Hospital  Service,  under  the  direction  of  the  Secretary  of  the  Treasury,  to  perform  all 
the  duties  in  respect  to  quarantine  and  quarantine  regulations  which  are  provided 
for  by  this  act,  and  to  obtain  information  of  the  sanitary  condition  of  foreign  ports  and 
places  from  which  contagious  and  infectious  diseases  are  or  may  be  imported  into  the 
United  States;  and  to  this  end  the  consular  officers  of  the  United  States  at  such  ports 
and  places  as  shall  be  designated  by  the  Secretary  of  the  Treasury  shall  make  to  the 
Secretary  of  Treasury  weekly  reports  of  the  sanitary  condition  of  the  ports  and  places 
at  which  they  are  respectively  stationed,  according  to  such  forms  as  the  Secretary  of 
the  Treasury  shall  prescribe;  and  the  Secretary  of  the  Treasury  shall  also  obtain, 
through  all  sources  accessible,  including  State  and  municipal  sanitary  authorities 
throughout  the  United  States,  weekly  reports  of  the  sanitary  condition  of  ports  and 
places  within  the  United  States,  and  shall  prepare,  publish,  and  transmit  to  collec- 
tors of  customs  and  to  State  and  municipal  health  officers  and  other  sanitarians  weekly 
abstracts  of  the  consular  sanitary  reports  and  other  pertinent  information  received  by 
him,  and  shall  also,  as  far  as  he  may  be  able,  by  means  of  the  voluntary  cooperation 
of  State  and  municipal  authorities,  of  public  associations  and  private  persons,  procure 
information  relating  to  the  climatic  and  other  conditions  affecting  the  public  health, 
and  shall  make  an  annual  report  of  his  operations  to  Congress,  with  such  recommen- 
dations as  he  may  deem  important  to  the  public  interest. 

Sec  5.  That  the  Secretary  of  the  Treasury  shall  from  time  to  time  issue  to  the  con- 
sular officers  of  the  United  States  and  to  the  medical  officers  serving  at  any  foreign 
port,  and  otherwise  make  publicly  known,  the  rules  and  regulations  made  by  him,  to 
be  used  and  complied  with  by  vessels  in  foreign  ports,  for  securing  the  best  sanitary 
conditions  of  such  vessels,  their  cargoes,  passengers,  and  crew,  before  their  departure 
for  any  port  in  the  United  States  and  in  the  course  of  the  voyage,  and  all  such  other 
rules  and  regulations  as  shall  be  observed  in  the  inspection  of  the  same  on  the  arrival 
thereof  at  any  quarantine  station  at  the  port  of  destination,  and  for  the  disinfection 
and  isolation  of  the  same,  and  the  treatment  of  cargo  and  persons  on  board,  so  as  to 
prevent  the  introduction  of  cholera,  yellow  fever,  or  other  contagious  or  infectious 
diseases;  and  it  shall  not  be  lawful  for  any  vessel  to  enter  said  port  to  discharge  its 
cargo  or  land  its  passengers  except  upon  a  certificate  of  the  health  officer  at  such 
quarantine  station  certifying  that  said  rules  and  regulations  have  in  all  respects  been 


10  INTERSTATE    QUARANTINE    REGULATIONS. 

observed  and  complied  with,  as  well  on  his  part  as  on  the  part  of  the  said  vessel  and 
its  master,  in  respect  to  the  same  and  to  its  cargo,  passengers,  and  crew;  and  the 
master  of  every  such  vessel  shall  produce  and  deliver  to  the  collector  of  customs  at 
said  port  of  entry,  together  with  the  other  papers  of  the  vessel,  the  said  bills  of  health 
required  to  be  obtained  at  the  port  of  departure  and  the  certificate  herein  required  to 
be  obtained  from  the  health  officer  at  the  port  of  entry,  and  that  the  bills  of  health 
herein  prescribed  shall  be  considered  as  part  of  the  ship 's  papers,  and  when  duly  cer- 
tified to  by  the  proper  consular  or  other  officer  of  the  United  States,  over  his  official 
signature  and  seal,  shall  be  accepted  as  evidence  of  the  statements  therein  contained 
in  any  court  of  the  United  States. 

Sec.  6.  That  on  the  arrival  of  an  infected  vessel  at  any  port  not  provided  with 
proper  facilities  for  treatment  of  the  same  the  Secretary  of  the  Treasury  may  remand 
said  vessel,  at  its  own  expense,  to  the  nearest  national  or  other  quarantine  station, 
where  accommodations  and  appliances  are  provided  for  the  necessary  disinfection 
and  treatment  of  the  vessel,  passengers,  and  cargo,  and  after  treatment  of  any  infected 
vessel  at  a  national  quarantine  station,  and  after  certificate  shall  have  been  given  by 
the  United  States  quarantine  officer  at  said  station  that  the  vessel,  cargo,  and  pas- 
sengers are  each  and  all  free  from  infectious  disease,  or  danger  of  conveying  the  same, 
said  vessel  shall  be  admitted  to  entry  to  any  port  of  the  United  States  named  within 
the  certificate.  But  at  any  ports  where  sufficient  quarantine  provision  has  been 
made  by  State  or  local  authorities  the  Secretary  of  the  Treasury  may  direct  vessels 
bound  for  said  ports  to  undergo  quarantine  at  said  State  or  local  station. 

Sec.  7.  That  whenever  it  shall  be  shown  to  the  satisfaction  of  the  President  that 
by  reason  of  the  existence  of  cholera  or  other  infectious  or  contagious  diseases  in  a 
foreign  country  there  is  serious  danger  of  the  introduction  of  the  same  into  the  United 
States,  and  that  notwithstanding  the  quarantine  defense  this  danger  is  so  increased 
by  the  introduction  of  persons  or  property  from  such  country  that  a  suspension  of  the 
right  to  introduce  the  same  is  demanded  in  the  interest  of  the  public  health,  the 
President  shall  have  power  to  prohibit,  in  whole  or  in  part,  the  introduction  of  per- 
sons and  property  from  such  countries  or  places  as  he  shall  designate  and  for  such 
period  of  time  as  he  may  deem  necessary. 

Sec  8.  That  whenever  the  proper  authorities  of  a  State  shall  surrender  to  the 
United  States  the  use  of  the  buildings  and  disinfecting  apparatus  at  a  State  quarantine 
station  the  Secretary  of  the  Treasury  shall  be  authorized  to  receive  them  and  to  pay 
a  reasonable  compensation  to  the  State  for  their  use,  if,  in  his  opinion,  they  are  nec- 
essary to  the  United  States. 

Sec.  9.  That  the  act  entitled  "An  act  to  prevent  the  introduction  of  infectious  or 
contagious  diseases  into  the  United  States,  and  to  establish  a  national  board  of  health, ' ' 
approved  March  3,  1879,  be,  and  the  same  is  hereby,  repealed.  And  the  Secretary 
of  the  Treasury  is  directed  to  obtain  possession  of  any  property,  furniture,  books, 
paper,  or  records  belonging  to  the  United  States,  which  are  not  in  the  possession  of 
an  officer  of  the  United  States  under  the  Treasury  Department,  which  were  formerly 
in  the  use  of  the  National  Board  of  Health  or  any  officer  or  employee  thereof. 

An  act  to  amend  section  two  of  the  act  approved  February  15,  1893,  entitled  "An  act 
granting  additional  quarantine  powers  and  imposing  additional  duties  upon  the 
Marine-Hospital  Service." 

(U.  S.  Stats,  at  Large,  vol.  28,  ch.  300,  p.  372.    Approved  Aug.-18, 1894.) 

Be  it  enacted  by  the  Senate  and  House  of  Representatives  of  the  United  States  of  America 
in  Congress  assembled,  That  section  two  of  the  act  approved  February  fifteenth,  eighteen 
hundred  and  ninety-three,  entitled  "An  act  granting  additional  quarantine  powers 
and  imposing  additional  duties  upon  the  Marine-Hospital  Service,"  is  hereby  amended 
by  adding  to  the  end  of  said  section  the  following: 


INTERSTATE    QUARANTINE    REGULATIONS.  11 

The  provisions  of  this  section  shall  not  apply  to  vessels  plying  between  foreign  ports 
on  or  near  the  frontiers  of  the  United  States  and  ports  adjacent  thereto;  but  the  Sec- 
retary of  the  Treasury  is  hereby  authorized,  when,  in  his  discretion,  it  is  expedient 
for  the  preservation  of  the  public  health,  to  establish  regulations  governing  such 
vessels. 

An  act  to  amend  '"An  act  granting  additional  quarantine  powers  and  imposing  addi- 
tional duties  upon  the  Marine-Hospital  Sendee,"  approved  February  15,  1893. 

(U.  S.  Stats,  at  Large,  vol.  31,  ch.  836,  p.  1086.    Approved  Mar.  3, 1901.) 

Be  it  enacted  by  the  Senate  and  House  of  Representatives  of  the  United  States  of  America 
in  Congress  assembled,  That  "an  act  granting  additional  quarantine  powers  and  impos- 
ing additional  duties  upon  the  Marine-Hospital  Service,"  approved  February  15, 1893, 
be  amended  by  addition  of  the  following  sections: 

Sec.  10.  That  the  supervising  Surgeon  General,  with  the  approval  of  the  Secretary 
of  the  Treasury,  is  authorized  to  designate  and  mark  the  boundaries  of  the  quarantine 
grounds  and  quarantine  anchorages  for  vessels  which  are  reserved  for  use  at  each 
United  States  quarantine  station;  and  any  vessel  or  officer  of  any  vessel  or  other  per- 
son other  than  State  or  municipal  health  or  quarantine  officers,  trespassing  or  otherwise 
entering  upon  such  grounds  or  anchorages  in  disregard  of  the  quarantine  rules  and 
regulations,  or  without  permission  of  the  officer  in  charge  of  such  station,  shall  be 
deemed  guilty  of  a  misdemeanor  and  subject  to  arrest,  and  upon  conviction  thereof 
be  punished  by  a  fine  of  not  more  than  three  hundred  dollars  or  imprisonment  for  not 
more  than  one  year,  or  both,  in  the  discretion  of  the  court.  Any  master  or  owner  of 
any  vessel,  or  any  person  violating  any  provision  of  this  act  or  any  rule  or  regulation 
made  in  accordance  with  this  act,  relating  to  inspection  of  vessels  or  relating  to  the 
prevention  of  the  introduction  of  contagious  or  infectious  diseases,  or  any  master, 
owner,  or  agent  of  any  vessel  making  a  false  statement  relative  to  the  sanitary  condi- 
tion of  said  vesssel  or  its  contents  or  as  to  the  health  of  any  passenger  or  person  thereon, 
shall  be  deemed  guilty  of  a  misdemeanor  and  subject  to  arrest,  and  upon  conviction 
thereof  be  punished  by  a  fine  of  not  more  than  five  hundred  dollars  or  imprisonment 
for  not  more  than  one  year,  or  both,  in  the  discretion  of  the  court. 

Sec.  11.  That  any  vessel  sailing  from  any  foreign  port  without  the  bill  of  health 
required  by  section  two  of  this  act,  and  arriving  within  the  limits  of  any  collection 
district  of  the  United  States,  and  not  entering  or  attempting  to  enter  any  port  of  the 
United  States,  shall  be  subject  to  such  quarantine  measures  as  shall  be  prescribed  by 
regulations  of  the  Secretary  of  the  Treasury,  and  the  cost  of  such  measures  shall  be  a 
lien  on  said  vessel,  to  be  recovered  by  proceedings  in  the  proper  district  court  of  the 
United  States  and  in  the  manner  set  forth  above  as  regards  vessels  from  foreign  ports 
without  bills  of  health  and  entering  any  port  of  the  United  States. 

Sec.  12.  That  the  medical  officers  of  the  United  States,  duly  clothed  with  authority 
to  act  as  quarantine  officers  at  any  port  or  place  within  the  United  States,  and  when 
performing  the  said  duties,  are  hereby  authorized  to  take  declarations  and  administer 
oaths  in  matters  pertaining  to  the  administration  of  the  quarantine  laws  and  regulations 
of  the  United  States. 


INTERSTATE  QUARANTINE  REGULATIONS. 


Treasury  Department, 

Office  of  the  Secretary, 
Washington,  January  15,  1916. 
To  medical  officers  of  the   United  States  Public  Health  Service,  State 
and  local  health  authorities,  and  others  concerned: 
Upon  the  recommendation  of  the  Surgeon  General  of  the  United 
States  Public  Health  Service  and  pursuant  to  the  act  of  Congress 
approved  February  15,  1893,  entitled  "An  act  granting  additional 
quarantine  powers  and  imposing  additional  duties  upon  the  Marine- 
Hospital  Service,"   the  following  interstate  quarantine  regulations 
for  the  prevention  of  the  introduction  of  contagious  and  infectious 
diseases  into  one  State  or  Territory  or  the  District  of  Columbia  from 
another  State  or  Territory  or  the  District  of  Columbia  are  hereby 
promulgated  for  the  information  and  guidance  of  all  concerned. 
All  regulations  inconsistent  herewith  are  hereby  revoked. 

W.  G.  McAdoo,  Secretary. 
13 


INTERSTATE  QUARANTINE  REGULATIONS. 

Section.  1 .  For  the  purposes  of  interstate  quarantine .  contagious   or 
the  following  diseases  shall  be  regarded  as  contagious  and  eases.     Act  ap- 
inf  ectious  diseases  within  the  meaning  of  section  3  of  the  1893,  u.  s.  stats! 
act  approved  February  15,  1893 :  Plague,  cholera,  typhoid  ch.  444,  p.  114. 
fever,  pulmonary  tuberculosis,  yellow  fever,  smallpox, 
leprosy,  typhus  fever,  scarlet  fever,  diphtheria,  measles, 
whooping  cough,  poliomyelitis  (infantile  paralysis),  Rocky 
Mountain  spotted  or  tick  fever,  and  epidemic  cerebro- 
spinal meningitis;   and  any  person  affected  with  any  dis- 
ease aforesaid,  and  anything,  living  or  dead,  which  has 
been  affected  with  or  exposed  to  the  contagion  or  infec- 
tion of  any  such  disease,  except  as  otherwise  provided  in 
these  regulations,  shall  be  regarded  as  contagious  or  infec- 
tious until  the  contrary  has  been  proven. 

Sec.  2.  Common  carriers  by  land  or  water,  while  interstate  veM- 
engaging  in  commerce  between  any  of  the  several  States 
or  Territories  or  the  District  of  Columbia,  shall  maintain 
at  all  times  in  a  clean  and  sanitary  condition  all  cars, 
vessels,  vehicles,  or  conveyances  so  being  operated  by 
them. 

Sec.  3.  The  living  quarters  for  the  personnel  of  vessels    Fumigation  of 
shall  be  fumigated  at  least  once  every  six  months  for  the  approved  Mar.  9, 
extermination  of  insects  and  vermin,  and  also  upon  the 
removal  of  a  case  or  cases  of  any  disease  mentioned  in 
section  1. 

Sec.  4.  Common  carriers  shall  not  permit,  nor  cause,   cleaning  of 
to  be  cleaned  any  car,  vessel,  vehicle,  or  other  conveyance 
operating  in  interstate  traffic  while  the  same  is  occupied 
by  passengers,  unless  said  cleaning  is  done  in  such  manner 
as  to  prevent  the  distribution  of  dust. 

Sec.  5.  Any  person,  firm,  or  corporation  supplying  Bedding. 
sleeping  accommodations  for  passengers  traveling  in 
interstate  traffic  shall  furnish  the  bed,  couch,  or  other 
appliance  used  for  sleeping  purposes  with  clean  sheets  and 
pillowcases  which  have  not  been  used  by  any  other  per- 
son since  last  laundered:  Provided,  That  blankets,  pil- 
lows, and  mattresses  which  have  not  been  used  by  any 
person  suffering  from  a  disease  mentioned  in  section  1,  if 
27165°— 16 3  15 


atones 


16  INTERSTATE    QUARANTINE    REGULATIONS. 

physically  clean  and  free  from  vermin,  may  be  used  if 
they  are  so  enveloped  as  not  to  come  in  contact  in  any 
way  with  any  occupant  of  such  bed,  couch,  or  other 
appliance  for  sleeping  purposes. 

ventilation.  Sec.  6.  All  cars,  vessels,  vehicles  or  conveyances  oper- 
ating for  the  use  of  passengers  traveling  in  interstate 
traffic  shall  be  so  ventilated  as  to  insure  an  adequate  sup- 
ply of  fresh  air. 

Toilets  and  lav-  gEC>  7  .  Toilets  and  lavatories  on  cars,  vessels,  vehicles, 
or  conveyances  operating  for  the  use  of  passengers  travel- 
ing in  interstate  traffic  shall  be  of  adequate  size,  design, 
and  number,  and  shall  be  maintained  in  a  clean  and  san- 
itary condition. 

Prevention    of     gEC>  g#  Common  carriers  by  land  or  water  while  en- 

spitttmg.  _  J 

gaging  in  commerce  between  any  of  the  several  States  or 
Territories  or  the  District  of  Columbia  shall  take  adequate 
measures  by  the  use  of  warning  signs  or  cuspidors,  or 
both,  for  the  prevention  of  the  soiling  of  cars,  vessels, 
vehicles,  or  conveyances  with  sputum,  and  said  cuspi- 
dors shall  be  adequate  in  size  and  number  and  suitable  in 
design  for  the  reception  of  sputum,  and  shall  be  main- 
tamed  in  a  clean  and  sanitary  condition. 
common  tow-  gEC#  g_  Common  carriers  shall  not  provide  in  cars, 
Dec.  9, 1912.  vessels,  vehicles,  or  conveyances  operated  in  interstate 
traffic,  or  in  depots,  waiting  rooms,  or  other  places  used 
by  passengers  traveling  from  one  State  or  Territory  or  the 
District  of  Columbia  to  another  State  or  Territory  or  the 
District  of  Columbia,  any  towel  for  use  by  more  than  one 
person:  Provided,  That  towels  may  be  used  again  after  hav- 
ing been  cleansed  and  sterilized  with  boiling  water, 
commondrink-     gEC#  iq.  Common  carriers  shall  not  provide  in  cars, 

mg  cup .  ,  t 

Oct.  30, 1912.  vessels,  vehicles,  or  conveyances  operated  in  interstate 
traffic,  or  in  depots,  waiting  rooms,  or  other  places  used 
by  passengers  traveling  from  one  State  or  Territory  or 
the  District  of  Columbia  to  another  State  or  Territory  or 
the  District  of  Columbia,  any  drinking  cup,  glass,  or  vessel 
for  common  use:  Provided,  That  this  regulation  shall  not 
be  held  to  preclude  the  use  of  drinking  cups,  glasses,  or 
vessels  which  are  thoroughly  cleansed  or  sterilized  after 
use  by  each  individual,  nor  shall  it  be  held  to  preclude  the 
use  of  sanitary  devices  for  individual  use  only. 

rood  and  drink     gEC   \\    Persons,  firms,  or  corporations  engaging  in  the 

for  interstate  pas-  t  *  '  *  m  &    g      t> 

sengers.  business  of  furnishing  food  or  drink  for  the  use  of  pas- 

sengers traveling  in  interstate  traffic  shall  not  supply 
any  article  of  food  or  drink,  unless  the  same  shall  have 


INTERSTATE    QUARANTINE    REGULATIONS. 


been  obtained  from  a  source  known 
contagion  or  infection  of  the  dise^ 
tion  1,  or  unless  the  same  shall  h 
teurized,  or  otherwise  treated  in  s 
that  the  article  is  free  from  the  ' 
tagion  or  infection  as  afores? 
or  drink  for  said  passengers 
as  to  prevent  contamir>r 
infection. 

Sec.  12.  After  no 
health  authorities 
or  accept  for  t 
from  premise 
scarlet  f  e^ 
fever,  ul 
that   i 
sur* 


INTERSTATE    QUARANTINE    REGULATIONS. 


~>n  carriers  while  engaging  in  interstate 
"sh  to  their  crews  or  employees  any 
ong  purposes  which  may  contain 
i  likely  to  cause  a  contagious  or 
shall  such  carriers  maintain  or 
->on  their  vessels  or  vehicles,  or 
u-  other  ordinary  stopping 
ve  control  any  tank,  cis- 
;cle  with  water  which 
h  manner  that  water 
med  by  the  crews 
purposes,  unless 
on  said  vessels 
^k,  cistern, 
,ok,  pool, 
in  con- 
^ater 
d 


INTERSTATE    QUARANTINE    REGULATIONS.  19 

under  date  of  October  21,  1914  ■}  Provided,  That  water  in 
regard  to  the  safety  of  which  a  reasonable  doubt  exists 
may  be  used  if  the  same  has  been  treated  in  such  manner 
as  to  render  it  incapable  of  conveying  disease,  and  the 
fact  of  such  treatment  is  certified  by  the  aforesaid  health 
authority  or  by  the  Surgeon  General  of  the  United  States 
Public  Health  Service  or  his  accredited  representative. 

Sec.  17.  Common  carriers  shall  not  knowingly  accept  .interstate  car- 

.  .r     riage  ofcommuni- 

for  transportation  from  one  State  or  Territory  or  the  cable  disease. 
District  of  Columbia  into  another  State  or  Territory  or 
the  District  of  Columbia  any  person  suffering  from  any 
of  the  diseases  mentioned  in  section  1,  except  as  herein- 
after provided. 

Sec.  18.  No  person  knowing  that  he  is  in  the  communi-    Travel  of  per- 

t  i        ,  n  i?i-iv  .1"  i--<  sons  having  corn- 

Cable  stage  oi  any  ol  the  diseases  enumerated  in  section  1  municabie    dis- 

shall  travel  on  any  car,  vessel,  vehicle,  or  conveyance9 ' 
engaging  in  interstate  traffic,  except  as  hereinafter  pro- 
vided, nor  shall  any  parent  or  guardian  allow  any  minor, 
or  other  person  under  his  charge  who  is  in  the  communi- 
cable stage  of  any  of  such  diseases,  to  travel  in  any  car, 
vessel,  vehicle,  or  conveyance  engaging  in  interstate 
traffic. 

Sec.  19.  No  person,  firm,  or  corporation  shall  offer  for    Transportation 

.        .  rr-  i  •  things  exposed 

shipment  m  interstate  traffic,  and  no  common  carrier  to  infection. 
shall  accept  for  shipment,  or  transport  in  interstate 
traffic,  any  article  or  thing  known  to  have  been  exposed 
to  the  contagion  or  infection  of  any  of  the  diseases  enu- 
merated in  section  1,  unless  a  certificate  has  previously 
been  obtained  from  the  proper  health  authority 3  that  all 
necessary  measures  have  been  taken  to  render  said  article 
or  thing  free  from  infection;  and  in  the  case  of  yellow 
fever,  Rocky  Mountain  spotted  or  tick  fever,  or  typhus 
fever,  free  from  mosquitoes,  ticks,  or  lice. 

Sec.  20.  In  the  event  of  the  appearance  of  human  or   outgoing  quar- 
rodent  plague  in  any  port  or  place  within  the  United  to tlprev^r,the 
States,  the  Surgeon  General  of  the  United  States  pubUc(*r<®dofI*aguo- 
Health  Service  shall  establish  such  outgoing  quarantine 
measures  as  will  in  his  opinion  prevent  the  introduction 
of  the  disease  into  another  State  or  Territory  or  the  Dis- 
trict of  Columbia :  Provided,  That  freight  which  is  known 
to  have  originated  in  rat-free  surroundings  and  is  shipped 
from  rat-proof,  rat-free  warehouses,  docks,  or  wharves, 

i  See  Appendix. 

2  The  term  "proper  health  authority"  shall  be  construed  to  mean  the  health  officer 
within  whose  .jurisdiction  the  article  or  thing  originates,  or  during  the  presence  of  epi- 
demic, the  officer  in  charge  of  the  measures  to  prevent  the  spread  of  same. 


20  INTER-STATE    QUARANTINE    REGULATIONS. 

in  rat-proof,  rat-free  cars,  vessels,  vehicles,  or  convey- 
ances, may  be  granted  pratique  for  interstate  transpor- 
tation when  so  certified  by  the  Surgeon  General  of  the 
United  States  Public  Health  Service  or  his  accredited 
representative. 
PrlVof  dLeas^  ^ec.  ^1«  Any  person  or  thing  either  living  or  dead, 
from  infected  per-  which  has  been  exposed  to  or  is  infected  with  any  of  the 

sons.  -1  .  m        J 

diseases  enumerated  in  section  1,  if  found  in  any  car, 
vessel,  vehicle,  or  conveyance  undergoing  interstate  trans- 
portation, shall  be  subjected  to  such  inspection,  disinfec- 
tion, or  other  measures  as  may  be  necessary  to  prevent 
the  spread  of  the  infection  from  them. 

sick  passenger.  Sec.  22.  In  the  event  of  the  appearance  of  any  disease 
mentioned  in  section  1,  with  the  exception  of  tuberculosis, 
in  any  person  en  route  or  aboard  any  car,  vessel,  vehicle, 
or  conveyance  operating  in  interstate  traffic,  the  common 
carrier  shall  at  once  isolate  the  sick  person  and  remove 
him  from  the  car,  vessel,  vehicle,  or  conveyance  at  the 
first  convenient  place  at  which  reasonable  provision  may 
be  had  for  the  protection  of  the  patient  and  the  public 
health,  and  shall  immediately  notify  the  Surgeon  General 
of  the  United  States  Public  Health  Service  and  the  State 
and  local  health  officer  of  the  place  at  which  the  person 
was  removed  from  such  car,  vessel,  vehicle,  or  convey- 
ance, and  shall  disinfect  the  compartment  from  which  the 
person  was  removed.1 

infected    per-     gEC>  23.  No    person    affected    with    plague,    cholera, 

sons  who  may  not  r  .        I 

travel.  smallpox,  scarlet  fever,  or  yellow  fever  shall  be  received 

upon  any  vessel,  car,  vehicle,  or  conveyance  operating 
in  interstate  traffic, 
interstate  car-     Sec.  24.  Commori  carriers  shall  not  receive  upon  any 

riage  of  typhoid  1  t  •    1  .  •         •      •     ,         •     . 

patients.  car,  vessel,  vehicle,  or  conveyance  operating  in  interstate 

traffic  any  person  affected  with  typhoid  fever,  unless  re- 
moval and  entrance  permits  have  been  granted  by  the 
State  or  local  health  officers  at  places  of  departure  and 
arrival,  and  unless  said  person  is  placed  in  a  separate 
compartment  and  is  accompanied  by  a  properly  qualified 
nurse  or  attendant,  and  unless  said  nurse  or  attendant 
shall  obligate  himself  or  herself  in  writing,  to  the  common 
carrier,  to  comply  with  the  following  regulations  while  in 
transit : 
Ruiesfomurses      (©)   1.  Communication  with  the  compartment  in  which 

accompanying  .  .  .  .  .  .    . 

typhoid  patients,  the  patient  is  traveling  shall  be  restricted  to  the  minimum 
consistent  with  the  proper  care  and  safety  of  the  patient. 

1  See  Appendix. 


INTERSTATE    QUARANTINE    REGULATIONS.  21 

2.  All  dishes  or  utensils  used  by  the  patient  en  route 
shall  be  placed  in  a  5  per  cent  solution  of  carbolic  acid  or 
in  disinfecting  fluid  of  equivalent  disinfecting  value  for 
at  least  one  hour  before  being  allowed  to  leave  the  com- 
partment. 

3.  All  urine,  bowel  movements,  or  other  discharges 
from  the  patient  shall  be  received  into  a  5  per  cent  solu- 
tion of  carbolic  acid  or  disinfecting  fluid  of  equivalent 
disinfecting  value,  placed  in  a  covered  vessel  and  allowed 
to  stand  undisturbed  for  at  least  two  hours  after  the  last 
addition  thereto;  upon  the  expiration  of  the  time  stated 
they  may  be  burned,  destroyed,  or  emptied  into  a  common 
sewer  at  any  convenient  port  or  place. 

4.  Said  nurse  or  attendant  shall  use  all  necessary  pre- 
cautions to  prevent  access  of  flies  to  the  patient,  and  after 
performing  service  of  any  nature  to  the  patient  shall  at 
once  cleanse  the  hands  by  thorough  washing  in  a  2  per 
cent  solution  of  carbolic  acid  or  other  solution  of  equiva- 
lent disinfecting  value. 

(&)  Immediately  upon  the  disembarkation  of  the  pa-    Disinfection  of 
tient  the  common  carrier  shall  close  the  compartment compar  men  ' 
the  patient  has  vacated,  without  removal  of  any  of  its 
contents,  and  shall  keep  the  same  closed  until  disinfected.1 

Sec.  25.  In  the  event  of  the  occurrence  of  a  case  of  yellow    Yellow  fever  en 

p  ,  li-i  route. 

lever  en  route  or  upon  any  car,  vessel,  vehicle,  or  conveyance 
operating  for  the  transportation  of  passengers  in  inter- 
state traffic,  the  case  shall  be  isolated  in  a  compartment 
or  place  so  screened  as  to  prevent  the  entrance  or  exit  of 
mosquitoes,  or  their  access  to  the  patient;  and  the  patient 
shall  not  be  disembarked  in  infectible  territory  unless 
thoroughly  protected  from  mosquitoes,  and  unless  per- 
mission for  such  disembarkation  has  been  obtained  from 
the  State  and  local  health  officials  having  jurisdiction 
over  the  place  of  disembarkation,  and  immediately  upon 
such  disembarkation  the  compartment  vacated  by  the 
patient  shall  be  fumigated  in  such  manner  as  to  insure 
the  complete  destruction  of  all  mosquitoes  contained 
therein. 

Sec.  26.  Common  carriers  shall  neither  cause,  permit,    Transportation 
or  allow  to  be  hauled,  removed,  or  transferred  in  inter-  cies  from  yellow 

,     ,       ,       m  li-i  p  fever  localities. 

state  traffic  any  car,  vessel,  vehicle,  or  conveyance  from 
a  locality  in  which  yellow  fever  prevails,  unless  there  has 
been  obtained  from  the  Surgeon  General  of  the  United 
States  Public  Health  Service,   or  his  accredited  repre- 

1  See  Appendix. 


22  INTERSTATE    QUARANTINE    REGULATIONS. 

sentative,    a    certificate    stating    that    said    car,    vessel, 
vehicle,  or  conveyance  has  been  fumigated   to  destroy 
mosquitoes,  or  has  been  so  safeguarded  as  to  prevent  the 
entrance  of  mosquitoes. 
Transportation     Sec.  27.  Common  carriers  shall  not  receive  upon  any 

of        diphtheria,  i  i  •    i  •     ,         j_    . 

measles,  and  car,  vessel,  vehicle,  or  conveyance  operatmg  in  interstate 
patients.  traffic  any  person  affected  with  diphtheria,  measles,  or 

whooping  cough,  or  any  person  known  to  be  a  carrier  of 
the  bacillus  diphtheriae,  unless  removal  and  entrance  per- 
mits have  been  granted  by  the  State  or  local  health  officers 
at  the  places  of  departure  and  arrival,  and  unless  said 
person  is  placed  in  a  separate  compartment  and  is  accom- 
panied by  a  properly  qualified  nurse  or  attendant  and 
unless  such  nurse  or  attendant  has  pledged  himself  or 
herself  in  writing,  to  the  common  carrier,  to  comply  with 
the  following  regulations  while  in  transit: 

(a)  1.  Communication  with  the  compartment  within 
which  the  patient  is  traveling  shall  be  restricted  to  the 
minimum  consistent  with  the  proper  care  and  safety  of 
the  patient. 

2.  All  dishes  or  utensils  used  by  the  patient  en  route 
shall  be  placed  in  a  5  per  cent  solution  of  carbolic  acid 
or  disinfecting  fluid  of  equivalent  disinfecting  value  for 
at  least  one  hour  before  being  allowed  to  leave  the 
compartment. 

3.  All  sputum  and  nasal  discharges  from  the  patient 
shall  be  received  in  gauze  or  paper,  which  shall  be 
deposited  into  a  closed  container  and  which  shall  be 
destroyed  by  burning  or  received  in  a  5  per  cent  solu- 
tion of  carbolic  acid  or  disinfecting  fluid  of  equivalent 
disinfecting  value  placed  in  a  covered  vessel  and  allowed 
to  stand  undisturbed  for  at  least  two  hours  after  the 
last  addition  thereto. 

(b)  Immediately  upon  the  disembarkation  of  the 
patient  the  common  carrier  shall  close  the  compartment 
the  patient  has  vacated,  without  the  removal  of  any 
of  its  contents,  and  shall  keep  the  same  closed  until 
disinfection.1 

ofTrTube°rrcuiou°     Sec.  28.  Common  carriers  shall  not  receive  for  inter- 

persons.  state  transportation  any  person  known  -by  them  to  be 

suffering  from  pulmonary  tuberculosis  in  a  communicable 

stage  unless  said  person  is  provided  with  the  following 

articles : 

1  See  Appendix. 


INTERSTATE    QUARANTINE    REGULATIONS.  23 

(a)  1.  A  sputum  cup  made  of  impervious  material  and 
so  arranged  or  constructed  to  admit  of  being  tightly 
closed  when  not  in  use.1 

2.  A  sufficient  supply  of  handkerchiefs,  gauze,  or 
similar  articles  of  sufficient  size  to  cover  the  nose  and 
mouth  while  coughing  and  sneezing.  Said  handkerchiefs, 
gauze,  or  similar  articles  shall  be  inclosed  in  a  tight  con- 
tamer  after  use  and  shall  be  destroyed  by  burning. 

3.  All  sputum  and  nasal  discharges  from  the  patient 
shall  be  received  in  gauze  or  paper,  which  shall  be  depos- 
ited in  a  closed  container  and  which  shall  be  destroyed  by 
burning  or  received  in  a  5  per  cent  solution  of  carbolic 
acid  or  disinf ecting  fluid  of  equivalent  disinfecting  value 
placed  in  a  covered  vessel  and  allowed  to  stand  undis- 
turbed for  at  least  two  hours  after  the  last  addition 
thereto. 

(b)  Immediately  upon  the  disembarkation  of  the 
patient  the  common  carrier  shall  close  the  compartment 
the  patient  has  vacated,  without  the  removal  of  any  of  its 
contents,  and  shall  keep  the  same  closed  until 
disinfection.2 

(c)  Passengers  in  interstate  traffic  having  pulmonary 
tuberculosis  in  a  communicable  stage  shall  not  expec- 
torate except  in  the  sputum  cup  or  gauze  aforementioned. 

Sec.  29.  Common  carriers  shall  not  accept  for  trans-    Transportation 

x  of  lepers. 

portation  nor  transport  in  interstate  traffic  any  person  suf-    Amendment  of 

fering  from  or  afflicted  with  leprosy  unless  there  has  been 

obtained  from  the  Surgeon  General  of  the  United  States 

Public-Health  Service,  or  his  accredited  representative, 

a  permit  stating  that  said  person  may  be  received  under 

such  restrictions  as  will  prevent  the  spread  of  the  disease, 

and  said  restrictions  shall  be  specified  in  each  instance: 

Provided,  That,  in  addition  to  the  above,  permits  shall 

also   be    obtained   from    the   health    authorities    of   the 

States,  Territories,  or  districts  to  and  from  which  the 

patient  intends  to  travel. 

Sec.  30.  No  person  knowing  or  having  reason  to  be-  Mayf^mT1  °f 
lieve  that  he  is  a  leper  shall  accept  transportation  or 
engage  in  travel  in  interstate  traffic  unless  permits  have 
been  obtained  as  set  forth  in  the  preceding  section  and 

1  The  common  carrier  should  require  any  such  person  to  refrain  from  spitting  in  any 
place  other  than  the  sputum  cup  above  mentioned,  and  in  the  event  of  coughing  or 
sneezing  to  so  cover  the  mouth  and  nose  with  a  handkerchief,  napkin,  or  similar  device 
as  to  prevent  the  ejection  of  particles  of  mucus  or  saliva  into  the  surrounding  atmos- 
phere. 

2  See  appendix. 


24  INTERSTATE    QUARANTINE    REGULATIONS. 

unless  said  person  shall  have  agreed  in  writing  to  com- 
ply with  the  restrictions  as  specified  in  the  permits  men- 
tioned above. 

Amendment  of  sEC.  3i.  Any  person  who  presents  symptoms  of  lep- 
rosy and  who  is  traveling  or  who  has  left  the  State  where 
he  resides  in  violation  of  the  above  regulations  shall  be 
detained  and,  if  proven  to  be  a  leper,  shall  be  returned 
to  such  State  or  removed  to  such  Federal  station  as  the 
Secretary  of  the  Treasury  may  designate  and  the  proper 
health  authorities  notified. 

incubation  Sec.  32.  For  the  purpose  of  these  regulations  the  fol- 
peno  s.  lowing  shall  be  considered  as  the  periods  of  incubation: 

Days  from 
Disease.  last  exposure. 

Plague 7 

Cholera 5 

Smallpox 14 

Yellow  fever 6 

Typhus  fever 12 

Typhoid  fever 14 

Scarlet  fever 7 

Diphtheria 4 

Whooping  cough 10 

Measles 14 

Notification  of  Sec.  33.  Interstate  sanitary  officers  and  State,  Territo- 
fectious  diseases,  rial,  and  other  health  authorities  who  will  undertake  to 
enforce  the  interstate  quarantine  regulations,  as  pro- 
vided by  section  3  of  the  interstate  quarantine  law  ap- 
proved February  15,  1893,  shall  notify  the  Surgeon  Gen- 
eral of  the  United  States  Public-Health  Service  imme- 
diately, by  telegraph  and  letter,  upon  the  occurrence  of  a 
case  or  cases  of  cholera,  yellow  fever,  typhus  fever,  or 
plague  and  shall  render  monthly  reports  as  to  the  preva- 
lence of  smallpox,  leprosy,  scarlet  fever,  diphtheria, 
typhoid  fever,  poliomyelitis  (infantile  paralysis),  epi- 
demic cerebrospinal  meningitis,  Rocky  Mountain  spotted 
or  tick  fever,  tuberculosis,  and  other  diseases  notifiable 
in  their  respective  jurisdictions. 
Notification  of     Sec.  34.  Upon  the  occurrence  of  an  unusual  outbreak, 

unusual  outbreak  .         .  .i>  i  i  •  .       ,-,  ■,  . 

ofdisease.  or  in  the  event  01  a  sudden  increase  m  the  number  ot 

cases  of  smallpox,  scarlet  fever,  diphtheria,  typhoid 
fever,  poliomyelitis  (infantile  paralysis),  epidemic  cere- 
brospinal meningitis,  Rocky  Mountain  spotted  or  tick 
fever,  or  epidemic  septic  sore  throat  in  any  locality,  the 
Surgeon  General  of  the  United  States  Public  Health 
Service  shall  be  immediately  notified  by  telegraph  and 
letter  of  such  unusual  outbreak  or  sudden  increase  by 


INTERSTATE    QUARANTINE    REGULATIONS.  25 

the  officers  and  authorities  mentioned  in  the  preceding 
section. 

Sec.  35.  Commissioned  medical  officers  of  the  United  interstate  sani- 
States  Public  Health  Service,  when  detailed  as  interstate taryofflcers- 
sanitary  officers,  shall  cooperate  with  State,  municipal,  and 
other  health  authorities  in  the  execution  of  their  regula- 
tions, as  provided  by  section  3  of  the  act  of  February  15, 
1893,  and  shall  enforce  these  regulations  and  collect 
epidemiological  and  sanitary  information  and  perform 
such  other  duties  in  such  manner  as  the  Secretary  of  the 
Treasury  may  approve. 

Sec.  36.  During  the  period  beginning  March  15  and    shipment  ani- 

, .  ?         i  ■  i  mals  f rom  locali- 

endmg  June  15  oi  each  year  common  carriers  shall  not ties  infected  with 

m        .  .  ,  Rocky  Mountain 

accept  lor  interstate  shipment,  and  no  person  shall  offer  spotted  fever. 
for  interstate  shipment,  any  cattle,  horses,  sheep,  goats, 
elk,  deer,  or  hogs  originating  in  a  locality  where  Rocky 
Mountain  spotted  fever  is  known  to  exist,  unless  said 
shipment  is  accompanied  by  a  certificate  from  a  Federal, 
State,  or  local  health  authority,  or  an  inspector  of  the 
Bureau  of  Animal  Industry  of  the  United  States  Depart- 
ment of  Agriculture,  or  a  State  veterinarian  or  his 
deputy,  setting  forth  that  the  said  animals  are  free  of  all 
attached  wood  ticks,  or  have  been  freed  thereof  by  hand 
picking,  spraying,  or  dipping  in  a  disinfectant  solution 
of  sufficient  strength  and  for  a  sufficient  time  to  kill  all 
ticks  attached  to  the  said  animals,  such  hand  picking, 
spraying,  or  dipping  to  be  accomplished  immediately 
prior  to  leaving  the  infected  territory. 


APPENDIX. 


DISINFECTANTS. 


Disinfectants  are  usually  divided  into  the  following  general  classes: 

1.  Physical  agents,  including  sunlight,  dry  heat,  burning,  boiling,  steaming,  elec- 
tricity, etc. 

2.  Gaseous,  including  formaldehyde,  sulphur  dioxide,  chlorine,  etc. 

3.  Chemical  solutions,  including  bichloride  of  mercury,  formalin,  carbolic  acid, 
tricresol,  lysol,  creolin,  potassium  permanganate,  lime,  chlorinated  lime,  the  hypo- 
chlorites, etc. 

With  the  exception  of  heat,  sulphur  dioxide  is  the  only  one  of  the  above-mentioned 
disinfectants  that  is  used  to  any  extent  as  an  insecticide,  while  other  substances  used 
for  this  purpose  are  hydrocyanic  acid  gas,  pyrethrum,  petroleum,  etc. 

PHYSICAL   DISINFECTANTS. 

turning. — Of  unquestioned  efficiency,  but  seldom  used. 

-\ — Very  efficient  and  of  wide  range  of  applicability.    The  articles  must  be 

^ed  for  not  less  than  10  minutes  in  water  actually  boiling  (100°  C).     The 

■•mt  of  carbonate  of  soda  renders  the  process  applicable  to  polished 

When  formalin  is  ^ntS;  or  toolg  (articles  of  aiuminum  excepted), 
takes  place,  accompan,team  (not  under  pressure).  Fiowing  steam  (not  under 
produce  a  large  quantity  ,.suitable  conditions  is  an  efficient  disinfecting  agent.    The 
the  reaction  to  begin   or  aj  w  minutes  after  the  temperature  hag  reached  100o  c 
minute  or  two,  depending  ^^  vacuum.  Steam  under  pressure  will  sterilize, 
a  few  minutes  and  withlg  continued  30  minutes  after  the  pressure  reaches  15  pounds 
almost  dry.  ^  r  must  be  expev]ed  from  tne  apparatU8  at  the  beginning  of 

A  convenient  and  efiycable  to  obtain  the  designated  pressure,  a  longer  exposure 
permanganate,  or  m  tr^  resuit 

latter^  By  using  a  gre^  ^^  vacuum:  steam  in  a  special  apparatus  with  vacuum 
may  be  evolved  trom  tmethod  of  applying  8team  under  pre8sure)  the  object  of  the 
ture  of  permanganate  to  expel  the  air  and  tQ  promote  the  penetration  of  the  steam 
comparatively  dry  stat^^  fm  3Q  minutes  after  ^  pressure  reacheg  10  dg  to 

additional  permangana'  r 

WF?r  mi5nPtnt0fornajUred  by  8team'  8UCh  aS  leather'  furs'  skins'  rubber'  trunks> 
or  mixmg        i    oinound  book    gdk    and  fine  wooieng  snoidd  not  De  disinfected 

suitable.     Pots  or  eart     „r,-    ij  u    j*  •  e    *  j  x,     £         \i  i     -, 

nails  on  account  of  at  be  dlsmfected  b^  formaldehyde  gas  or  by  any  of 

I      '       .   .      ,,,      these  regulations  which  may  be  applicable  thereto.     Those 

before  mixing  the  forr         ■+..        t     ul    j--  j    ,  ji 

during  the  reaction  a  y  wettln^  should  be  ^infected  by  a  gaseous  agent. 

formalin  and  5  ounces1*  ^>Wge,  clean  and  in  good  condition    but  suspected  of 

be  thrown  over,  so  tha<       efficiently  and  least  injuriously  disinfected  by  formalde- 

to  protect  the  carpet  o  gaseous  disinfectants. 

in  using  a  pail  with  a 

the  reaction,  which  isquantities  of  disinfectant  substances  to  be  used  for  gaseous 
placed  upon  a  noninP  contents  of  the  space  to  be  disinfected  should  always  be 
With  this  method  tents  are  usually  expressed  in  terms  of  a  thousand  cubic  feet, 
volume  that  it  is  unn  27 


28  INTERSTATE    QUARANTINE    REGULATIONS. 

A  room,  each  dimension  of  which  is  10  feet,  contains  1,000  cubic  feet,  and  the 
cubic  contents  of  any  space  can  be  determined  by  multiplying  together  the  length, 
width,  and  height,  expressed  in  feet,  which  will  give  the  contents  in  cubic  feet. 

To  prevent  the  escape  of  the  gas  from  the  inclosure  to  be  disinfected,  fireplaces, 
ventilators,  cracks  of  doors  and  windows,  and  other  openings  can  be  stuffed  with 
cotton,  paper,  cloths,  etc.,  but  they  are  best  closed  by  pasting  them  up,  for  which 
purpose  strips  of  newspaper  and  a  paste  made  from  flour  can  be  used. 

All  articles  to  be  disinfected  should  be  well  exposed  to  the  action  of  the  disin- 
fectant, as  the  penetrating  powers  of  all  gaseous  disinfectants  are  more  or  less  limited ; 
therefore  articles  should  either  be  hung  up  or  otherwise  freely  exposed  to  the  gas. 

FORMALDEHYDE . 

For  disinfection  purposes  formaldehyde  gas  is  usually  produced  from  the  aqueous 
solution  of  the  gas,  the  official  (TJ.  S.  P.)  name  of  which  is  "solution  of  formaldehyde." 
The  common  commercial  name  for  it,  however,  is  "formalin,"  and  since  this  name 
has  been  used  in  designating  one  of  the  principal  methods  of  producing  the  gas — 
namely,  the  "formalin-permanganate"  method — the  solution  will  be  referred  to 
under  the  name  of  "formalin." 

Formalin  is  supposed  to  contain  40  per  cent  of  formaldehyde  gas  by  volume,  but 
from  evaporation  and  deterioration  it  often  falls  short  of  this  quantity,  seldom  con- 
taining more  than  37  per  cent  of  the  gas.    The  gas,  when  used  under  favorable  con- 
ditions, is  one  of  the  most  powerful  germicides  at  our  disposal.     In  addition  to  its 
germicidal  efficiency  it  has  the  unique  advantage  over  most  other  disinfectant" 
that  it  is  not  injurious  to  the  ordinary  household  furnishings.     Furniture, 
wall  hangings,  paintings,  wearing  apparel,  and  fabrics,  with  the  possi1'" 
of  some  of  the  very  delicate  aniline  colors  and  polished  steel,  are  v 
exposures  to  the  action  of  this  gas. 

It  acts  quickly  as  a  germicide,  but  its  powers  of  penetrat 
it  is  necessary  to  have  articles  freely  exposed  in  order  to  im 
On  account  of  lack  of  penetrating  power  formaldehyde 
upon  to  disinfect  mattresses,  upholstered  furniture,  or  artii 
deep  penetration ;  consequently  instead  of  exposing  them  \ 
should  be  either  burned,  boiled,  steamed  (under  pressure),  q 
solution  in  order  to  make  sure  of  destroying  all  possible  infe^. 

Unfortunately  the  germicidal  powers  of  formaldehyde  ar 
climatic  conditions.  With  the  temperature  and  humidity  of- 
the  United  States  its  efficiency  as  a  surface  disinfectant  is  unqt 
temperature  is  about  or  below  50°  F.,  or  the  moisture  in  the. 
per  cent  of  saturation,  the  efficiency  of  formaldehyde  is  vej 
temperature  and  humidity  being  below  the  points  stated,  pol 
of  the  formaldehyde  takes  place  and  its  power  of  penetratioi 
slight,  is  still  further  diminished.  These  effects  of  low  tem 
may  in  part  be  overcome  in  room  disinfection  by  artificial  h« 
time  boiling  water  in  the  room,  by  sprinkling  the  floors  with  v 
an  increased  quantity  of  formaldehyde. 

Formaldehyde  gas  is  useless  as  an  insecticide  and  should 
purpose.     Flies  and  mosquitoes  are  killed  by  it  only  after  a  1 
in  concentrated  form.     It  is  nontoxic  to  the  higher  forms  of 
man,  but  produces  in  them  an  irritation  of  the  respiratory,  nat 
membranes,  thus  causing  coughing,  sneezing,  and  "watering' 
the  exposure  is  prolonged  these  effects,  however,  are  only  t- 
when  no  longer  exposed  to  the  gas. 

Formerly  formaldehyde  gas  was  largely  produced  by  means 
autoclaves,  etc.,  methods  requiring  special  apparatus  and  a  cert 


APPENDIX.  29 

ical  skill  in  operating,  but  those  methods  have  now  largely  been  supplanted  by  simpler 
ones  which  can  be  used  in  any  household.  In  view  of  this  fact,  only  the  following 
methods  of  evolving  the  gas  will  be  described: 

1.  Formalin-permanganate  method. 

2.  Formalin  sheet  spraying  method. 

3.  Formalin-aluminum  sulphate-lime  method. 

4.  Paraform. 

Regardless  of  which  method  is  used,  everything  should  be  in  readiness  before  the 
disinfection  process  is  started.  All  trunks  and  drawers  should  be  opened  and  most 
of  the  contained  articles  hung  up  or  otherwise  exposed  in  the  room,  particularly  if 
there  is  a  possibility  of  their  being  infected.  All  cupboards,  closets,  and  bookcases 
should  be  opened. 

Fireplaces,  ventilators,  and  cracks  of  doors  and  windows  to  be  closed  should,  with 
the  exception  of  the  doors  of  exit,  be  closed  before  the  disinfection  process  is  started. 

To  get  rid  of  the  formaldehyde  gas  remaining  after  disinfection  it  is  usually  sufficient 
to  open  the  doors  and  windows  and  allow  it  to  blow  out.  Ammonia  was  formerly  used 
to  a  limited  extent  for  neutralizing  the  gas,  but  as  it  often  causes  a  portion  of  it  to 
precipitate  in  the  form  of  a  powder,  which  when  heated  or  moistened  will  again  give 
off  a  certain  amount  of  formaldehyde  gas,  ammonia  is  now  seldom  used  for  that  pur- 
pose. Even  when  the  formaldehyde  is  allowed  to  blow  out  the  odor  of  the  gas  is 
often  perceptible  for  several  days  following  disinfection.  This,  however,  causes  no 
trouble  or  inconvenience. 

After  disinfection  with  formaldehyde  the  quarters  can  usually  be  occupied  an  hour 
or  two  after  opening  the  doors  and  windows. 

FORMALIN-PERMANGANATE    METHOD. 

When  formalin  is  poured  upon  crystals  of  permanganate  of  potash  a  vigorous  reaction 
takes  place,  accompanied  by  strong  ebullition  of  the  liquid  and  sufficient  heat  to 
produce  a  large  quantity  of  formaldehyde  gas,  water,  vapor,  etc .  The  time  required  for 
the  reaction  to  begin,  or  at  least  to  become  apparent,  varies  from  a  few  seconds  to  a 
minute  or  two,  depending  upon  the  temperature.  The  reaction  is  apparently  over  in 
a  few  minutes  and  with  proper  proportions  of  substances  the  residue  in  the  vessel  is 
almost  dry. 

A  convenient  and  efficient  proportion  to  use  is  two  parts  of  formalin  to  one  part  of 
permanganate,  or  in  the  proportion  of  a  quart  of  the  former  to  a  pound  (pint)  of  the 
latter.  By  using  a  greater  proportion  of  permanganate  than  this,  slightly  more  gas 
may  be  evolved  from  the  formalin,  but  in  addition  to  requiring  an  increased  expendi- 
ture of  permanganate  the  danger  of  fire  is  also  increased,  as  formaldehyde  gas  in  a 
comparatively  dry  state  is  inflammable.  The  increased  oxidation  resulting  from  the 
additional  permanganate  is  therefore  more  liable  to  cause  combustion  of  the  gas  than 
when  the  proportions  are  used  as  just  stated. 

For  mixing  the  formalin  and  permanganate  a  large  galvanized-iron  pail  is  very 
suitable.  Pots  or  earthern  vessels,  usually  being  thick,  are  not  as  suitable  as  thin 
pails,  on  account  of  absorbing  much  heat  from  the  reaction.  The  pail  may  be  heated 
before  mixing  the  formalin  and  permanganate.  On  account  of  the  vigorous  ebullition 
during  the  reaction  a  10-quart  pail  should  be  used  for  mixing  therein  10  ounces  of 
formalin  and  5  ounces  of  permanganate.  Even  then  a  few  drops  of  the  mixture  may 
be  thrown  over,  so  that  it  is  well  to  place  the  pail  in  a  large  tin  pan  or  upon  something 
to  protect  the  carpet  or  floor.  To  prevent  this  sputtering  over  there  is  some  advantage 
in  using  a  pail  with  a  flared  top.  As  the  process  is  attended  with  slight  danger  of  fire, 
the  reaction,  which  is  quickly  over,  should  be  watched  through  a  window  or  the  pails 
placed  upon  a  noninflammable  surface. 

With  this  method  the  formaldehyde  gas  is  evolved  so  quickly  and  in  such  a  large 
volume  that  it  is  unnecessary,  in  houses  with  well-fitting  doors  and  windows,  to  paste 


30  INTERSTATE    QUARANTINE    REGULATIONS. 

up  cracks  unless  only  a  portion  of  the  house  is  to  be  disinfected  and  the  remainder  is 
to  continue  to  be  occupied. 

Closets,  drawers,  trunks,  etc.,  should  be  opened,  and  when  everything  is  in  readi- 
ness the  permanganate  is  placed  in  the  pail  and  the  formalin  poured  over  it.  All 
inside  communicating  doors,  halls,  etc.,  should  be  opened  and  at  least  one  pail  placed 
in  each  room  and  hall,  unless  the  rooms  are  very  small.  Large  rooms  may  require 
more  than  one  pail  unless  a  pail  proportionately  large  is  used. 

The  quantity  of  formalin  and  permanganate  to  be  used  per  1,000  cubic  feet  of  room 
space  depends  upon  conditions.  If  the  atmosphere  is  warm  and  humid  10  ounces  of 
f  ormalin  and  5  ounces  of  permanganate  are  sufficient,  while  if  it  is  dry  and  cold  double 
these  quantities  should  be  used.  The  pails  should  be  distributed  about  in  the  room 
or  rooms  as  stated  and  the  necessary  quantity  of  permanganate  weighed  and  placed 
in  them.  The  formalin  for  each  pail  should  then  be  measured  into  a  wide-mouthed 
cup  or  vessel  and  placed  by  the  pail  in  which  it  is  to  be  used.  Do  not  use  narrow- 
necked  bottles  or  the  pouring  will  require  too  much  time.  Although  the  reaction  of 
formalin  with  permanganate  takes  place  quickly  by  making  preparations  as  advised 
one  operator  can  "set  off "  a  number  of  pails,  there  being  nothing  to  do  except  to  pour 
the  formalin  over  the  permanganate.  Of  course  the  mixing  should  begin  in  the  rooms 
most  distant  from  the  door  of  exit. 

The  time  of  exposure — that  is,  the  time  the  premises  should  be  kept  closed — should 
be  at  least  two,  and,  preferably,  four  hours.  At  the  end  of  this  time  the  doors  and 
windows  are  opened  and  the  gas  allowed  to  dissipate. 

FORMALIN    SHEET-SPRAYING   METHOD. 

This  is  a  very  simple  and  inexpensive  method  of  evolving  formaldehyde  gas  from 
formalin,  and  when  properly  used  under  favorable  conditions  is  efficient.  Formalin, 
sheets,  and  a  means  of  spraying  the  formalin  upon  the  sheets  are  all  that  are  required 
in  the  way  of  appliances.  The  sheets  should  be  hung  up  over  a  cord  or  line  and  allowed 
to  hang  at  an  angle  of  about  45°,  and  it  is  of  advantage,  too,  to  slightly  dampen  them 
with  water  before  hanging  them  up,  as  the  formalin  will  then  be  quickly  absorbed 
and  lessen  its  tendency  to  run  off  the  sheets. 

The  formalin  should  be  evenly  sprayed  upon  the  sheets,  which  can  be  done  with 
any  spraying  device,  a  very  simple  one  being  a  flower-watering  pot  provided  with  a 
sprinkler.  The  spraying  should  be  done  rather  quickly,  as  the  gas  soon  begins  to  be 
given  off.  The  process  should  be  carried  out  in  each  room.  Not  over  10  ounces  of 
formalin  should  be  used  for  eveiy  30  square  feet  of  sheet  surface.  The  area  of  a  sheet 
is  found  by  multiplying  its  length  by  its  breadth. 

This  method  is  particularly  applicable  where  a  long  exposure  may  be  allowed,  as 
the  gas  is  gradually  given  off  and  the  percentage  of  formaldehyde  remains  compara- 
tively high  during  a  relatively  long  time.  This  method  should  not  be  used  at  tem- 
peratures below  60°  F.,  as  the  formalin  polymerizes  on  the  sheets  and  very  Little  gas 
is  liberated.  "With  fairly  closely  fitting  doors  and  windows,  pasting  of  cracks  is  unnec- 
essary, unless  a  strong  wind  is  blowing.  However,  large  openings  like  fireplaces, 
openings  into  chimneys,  ventilators,  etc.,  should  be  closed  either  by  pasting  or  with 
bunches  of  old  rags. 

As  this  method  should  be  used  only  during  warm  months,  10  or  12  ounces  of  formalin 
for  each  1,000  cubic  feet  of  ah*  space  are  sufficient. 

The  time  of  exposure  should  be  from  four  to  six  hours.  Open  the  doors  and  win- 
dows and.  when  possible,  remove  the  sheets.  The  sheets  are  not  injured  in  any  way 
by  the  formalin. 

FORMALIN-ALUMINUM    SULPHATE-LIME    METHOD. 

In  this  method  2\  pounds  of  commercial  aluminum  sulphate  are  dissolved  in  2 
quarts  of  hot  water  and  allowed  to  stand  for  a  few  hours.  To  1  quart  of  this  solution 
3  quarts  of  formalin  are  added.     To  evolve  formaldehyde  gas  from  this  latter  solution 


APPENDIX.  31 

it  is  poured  over  unslaked  lime  in  the  proportion  of  10  ounces  of  the  solution  to  1 
pound  of  lime.  Just  before  using  the  lime  it  should  be  broken  into  small  particles. 
It  should  slake  easily  in  cold  water.  The  lime  should  be  placed  in  a  pail  or  vessel 
and  the  solution  poured  over  it.  A  few  minutes  after  pouring  the  formalin-aluminum 
sulphate  solution  over  the  lime,  the  latter  begins  to  slake  and  continues  for  20  to  30 
minutes,  during  which  time  formaldehyde,  steam,  etc.,  are  given  off.  The  percent- 
age of  formaldehyde  gas  liberated  by  this  method  is  relatively  small  as  compared 
with  the  formalin-permanganate  method,  but  since  a  small  quantity  of  formaldehyde 
is  efficient  when  used  under  favorable  climatic  conditions  this  method  will  then  give 
efficient  results.     This  method  should  not  be  used  in  cold,  dry  weather. 

About  15  ounces  of  formaUn-aluminum  sulphate  solution,  made  as  described  above, 
and  1J  pounds  of  lime  should  be  used  for  each  1,000  cubic  feet  of  air  space.  Cracks 
should  be  pasted  up  and  fireplaces  and  ventilators  closed,  as  the  percentage  of  gas 
given  off  is  relatively  small.  The  time  of  exposure  should  be  from  four  to  six  hours. 
The  process  should  be  carried  out  in  each  room. 

This  method  of  evolving  formaldehyde  gas  has  no  advantages,  but  several  disad- 
vantages, as  compared  with  the  formalin-permanganate  method,  and  is  now  seldom 
used.     It  is  not  as  efficient  as  the  sheet-spraying  method. 

PARAFORM. 

Paraform  can  be  used,  particularly  for  disinfecting  small  inclosures,  under  the 
same  conditions  of  heat  and  moisture  as  already  stated  with  regard  to  the  other 
methods. 

Paraform  is  one  of  the  polymeric  forms  of  formaldehyde.  It  is  a  white  powder  and 
readily  burns  with  a  blue  flame.  For  disinfecting  purposes  it  should  be  heated  to 
convert  the  paraform  into  formaldehyde  gas,  but  under  no  condition  should  it  be 
allowed  to  bum,  as  the  combustion  destroys  practically  all  of  the  formaldehyde. 
A  good  method  of  producing  formaldehyde  gas  from  paraform  is  to  place  the  paraform 
in  a  metal  utensil  under  which  a  lamp  or  alcohol  flame  can  be  arranged.  A  special 
lamp  or  device  can  be  obtained  for  the  purpose,  but  an  ordinary  pint  tin  cup  will 
suffice  for  heating  therein  an  ounce  or  two  of  paraform.  The  paraform  is  placed  in 
the  cup  and  a  flame  applied  underneath.  The  flame  should  not  be  too  strong,  for 
should  the  paraform  ignite  no  formaldehyde  gas  will  be  produced  and  there  will  be 
no  disinfection.  The  space  to  be  disinfected  should  be  tightly  closed  and  all  cracks 
pasted  up.  For  each  1,000  cubic  feet  of  air  space  2  ounces  of  paraform  should  be 
used.  The  time  of  exposure  should  be  about  four  hours.  If  necessary  the  flame 
under  the  utensil  containing  the  paraform  can  be  left  burning  during  the  time  of 
exposure. 

A  solution  of  paraform  can  be  made  and  used  in  the  same  manner  that  formalin  is 
used  in  the  formalin-permanganate  method.  For  disinfecting  1,000  cubic  feet  of 
space  2  ounces  of  paraform  are  dissolved  in  8  ounces  of  boiling  water.  This  solution 
is  then  poured  over  5  ounces  of  permanganate  of  potash  contained  in  a  2-gallon  pail, 
the  details  of  procedure  being  the  same  as  have  been  described  for  the  formalin- 
permanganate  method. 

There  are  many  forms  of  candles  and  other  preparations  of  paraform  made  and  sold 
upon  the  market  for  disinfection  purposes,  but  it  should  be  borne  in  mind  that  any 
preparation  of  paraform  requiring  that  the  compound  be  ignited  and  burned  in  order 
to  produce  formaldehyde  gas  is  useless  for  disinfection  purposes,  as  the  formaldehyde 
is  destroyed  by  the  combustion. 

In  using  those  preparations  of  paraform  that  are  heated  to  produce  the  gas,  due 
allowance  must  be  made  for  other  ingredients  than  paraform  contained  therein,  and 
therefore  a  larger  quantity  should  be  employed  than  when  using  pure  paraform,  as  at 
least  2  ounces  of  paraform  are  required  for  each  1,000  cubic  feet  of  space  to  be  dis- 
infected. For  the  reasons  stated,  the  use  for  disinfection  purposes  of  proprietary  prep- 
arations of  paraform  of  unknown  strengths  should  as  far  as  possible  be  avoided. 


32  INTERSTATE    QUARANTINE    REGULATIONS. 


SULPHUR   DIOXIDE. 


In  the  presence  of  moisture  sulphur  dioxide  is  an  efficient  surface  disinfectant.  Ita 
powers  of  penetration  are  limited,  and  it  will  not  kill  spores,  but  when  used  under 
favorable  conditions  it  will  kill  the  contagion  of  most  of  the  infectious  diseases  not 
due  to  spore-bearing  organisms.  Dry  sulphur  dioxide  (S02)  is  practically  without 
germicidal  powers,  but  in  the  presence  of  moisture  this  gas  is  converted  into  sulphurous 
acid  gas  (S03)  and  sulphuric  acid  (H2S04),  upon  which  efficient  disinfection  with 
sulphur  gas  depends.  While  these  converted  products  are  destructive  to  germ  life, 
they  are  also  injurious  to  household  furnishings,  fabrics,  etc.,  which  is  one  of  the 
greatest  drawbacks  to  the  use  of  sulphur  gas  as  a  disinfectant.  These  injurious  effects 
and  the  feeble  germicidal  properties  of  the  gas  in  the  dry  state  have  greatly  limited, 
its  uses,  particularly  in  household  disinfection,  but  it  is  still  especially  applicable 
for  destroying  rats,  flies,  fleas,  and  other  vermin  that  spread  contagion,  since  it  is 
highly  fatal  to  animal  life.  It  is,  therefore,  applicable  and  largely  used  for  disin- 
fecting holds  of  ships,  stables,  barns,  granaries,  freight  cars,  and  structures  of  this 
character.  Sulphur,  either  as  flowers  or  in  rolls  or  sticks,  can  usually  be  obtained  at 
any  drug  store  or  crossroads  store. 

In  the  presence  of  moisture  sulphur  dioxid  attacks  and  causes  oxidation  of  most  of 
the  metals,  which,  however,  can  be  prevented  by  previously  vaselining  the  exposed 
surfaces.  It  bleaches  and  injures  cotton,  linen,  and  woolen  fabrics,  curtains,  etc. 
It  injures  flour,  except  in  the  closed  ("headed  up  ")  barrel.  It  softens  paint  and  var- 
nish, particularly  if  they  have  been  recently  applied.  It  injures  soap,  coffee,  tea, 
sugar,  rice,  matches,  etc.,  when  they  are  freely  exposed  to  it.  It  injures  clocks,  and 
it  discolors  wall  paper  if  moisture  is  present. 

The  moisture  necessary  in  destroying  germ  life  with  sulphur  dioxide  can  usually  be 
artificially  produced  without  difficulty,  as  it  can  be  added  in  the  form  of  steam  (sulphur 
furnace),  and  in  the  pot  method  it  is  automatically  produced  from  the  water  in  the 
pan  in  which  the  sulphur  pot  is  placed.  However,  when  using  sulphur  dioxide  as  a 
disinfectant  in  damp  weather  or  in  disinfecting  holds  of  ships,  which  are  usually 
damp,  the  artificial  production  of  moisture  is  unnecessary. 

The  inclosure  to  be  disinfected  with  sulphur  gas  should  be  made  as  tight  as  possible: 
therefore  the  cracks  of  doors,  windows,  and  keyholes  should  be  pasted  up;  and  fireplaces, 
ventilators,  radiators,  and  all  openings  should  be  tightly  closed,  either  by  pasting 
or  in  some  other  manner.  This  should  all  be  done,  except  the  door  of  exit,  before 
starting  the  disinfection.  For  pasting,  strips  of  paper  and  a  paste  made  from  flour 
can  be  used.  After  the  disinfection  is  over  the  pastings  can  be  moistened  with 
water  and  washed  off.  It  is  necessary,  to  avoid  injury  to  the  articles  enumerated 
above,  to  remove  them  from  the  space  to  be  disinfected.  Brass  or  any  metal  furnish- 
ings are  not  injured,  provided  they  are  given  a  thin  coating  of  vaseline. 

The  principal  methods  of  using  sulphur  dioxide  are: 

1.  The  pot  method. 

2.  Liquid  sulphur  dioxide. 

3.  Sulphur  candles. 

THE   POT   METHOD. 

This  is  the  cheapest  and  simplest  method  of  producing  sulphur  dioxide.  The  only 
materials  required  are  pots,  sulphur,  and  a  small  quantity  of  alcohol.  Sulphur  bums 
when  liberally  sprinkled  with  alcohol  and  lighted.  It  can  also  be  started  burning 
by  placing  a  shovelful  of  hot  coals  of  fire  into  it.  As  sulphur  dioxide  is  produced  by 
combustion  of  the  sulphur,  and  as  the  combustion  is  dependent  upon  the  available 
oxygen  of  the  air,  it  will  readily  be  seen  that  the  rapidity  of  production  of  the  sulphur 
gas  will  be  governed  by  the  area  of  the  burning  surface.  It  is  therefore  very  important 
for  rapid  production  that  broad  shallow  pots  be  used. 


APPENDIX.  33 

Ordinary  "Dutch  ovens, "  iron  buckets,  etc.,  may  be  used,  but  the  best  pot  for  the 
purpose  is  one  rath  a  flat  bottom,  12  to  18  inches  in  diameter,  and  with  sides  about 
4  inches  high.     A  dish  pan  answers  the  purpose  very  well. 

Theoretically,  the  complete  combustion  of  1  pound  of  sulphur  in  a  space  of  1,000 
cubic  feet  produces  1.15  per  cent  of  sulphur  dioxide,  though  1  per  cent  is  about  what 
is  produced  in  actual  practice.  Therefore,  as  5  per  cent  is  required  to  kill  nonspore- 
bearing  organisms,  it  is  necessaiy  to  burn  5  pounds  of  sulphur  for  each  1,000  cubic 
feet  of  space  to  be  disinfected. 

After  estimating  the  cubic  space  to  be  disinfected  the  sulphur  should  be  weighed, 
allowing  5  pounds  for  every  1,000  cubic  feet  of  space. 

Sufficient  pots  should  be  available  so  that  a  depth  of  not  more  than  1J  to  2  inches 
of  sulphur  will  have  to  be  placed  in  each  pot,  although  necessity  sometimes  requires 
a  greater  depth  than  this.  The  sulphur  should  be  sloped  toward  the  center  so  as  to 
form  a  crater  or  depression. 

"When  using  stick  sulphur  a  portion  of  it  should  be  pulverized  or  broken  up.  The 
pots  should  be  distributed  in  the  rooms  to  be  disinfected"  according  to  the  size  of  the 
rooms  and  number  of  pots.  They  may  be  placed  upon  the  floor,  tables,  stoves, 
hearths,  etc. 

It  should  be  borne  in  mind  that  the  burning  sulphur  causes  the  pots  to  become 
very  hot.  and  to  avoid  danger  from  fire  it  is  necessary  to  place  them  upon  objects  not 
combustible  or  injured  by  heat.  As  already  stated,  this  is  best  accomplished  by 
arranging  them  in  pans  containing  an  inch  or  two  of  water,  as  besides  the  protection 
the  heat  produces  moisture  from  the  water  which  is  necessary  in  sulphur  disinfection. 
Pans  not  being  available,  the  pots  may  be  stood  upon  earthen  or  metal  surfaces  and 
efficient  disinfection  done,  provided  the  atmosphere  is  reasonably  damp.  Theoret- 
ically, about  3  ounces  of  water  should  be  volatilized  for  each  pound  of  sulphur  burned. 
The  sprinkling  of  the  sulphur  with  alcohol  and  righting  should  not  be  done  until 
everything  is  in  readiness.  A  convenient  and  safe  method  of  lighting  the  alcohol  in 
the  pots  is  to  strike  a  match  and  before  the  head  is  entirely  ignited  to  throw  it  into 
the  pot.  This  will  cause  the  alcohol  to  ignite.  After  lighting,  the  sulphur  fumes  do 
not  begin  to  come  off  for  a  few  minutes,  so  that  one  operator  can  start  a  number  of  pots. 
After  lighting  the  pots,  observe  that  they  are  all  burning;  then  close  the  door  of  exit 
and  paste  up  its  cracks. 

When  the  sulphur  has  been  burning  half  an  hour,  search  for  sulphur  fumes  escaping 
from  any  openings  that  may  have  been  overlooked  and  close  them. 

Leave  the  apartment  or  room  closed  for  12  hours,  and  then  open  doors,  windows, 
etc..  and  allow  the  remaining  sulphur  fumes  to  blow  out.  It  is  well  to  have  the  win- 
dows so  they  can  be  opened  from  the  outside,  otherwise  entrance  to  the  rooms  may 
be  impossible  for  an  hour  or  so.  The  rooms  can  usually  be  occupied  in  two  or  three 
hours  after  opening  the  doors  and  windows. 

LIQUID    SULPHUR   DIOXID. 

The  technique  of  disinfection  with  liquid  sulphur  dioxide  differs  from  the  pot 
method  only  in  the  manner  of  production;  therefore  that  is  the  only  phase  of  the  sub- 
ject that  will  be  described  here,  the  reader  being  referred  to  the  description  already 
given  for  further  details. 

The  method  has  the  advantage  of  liberating  a  large  quantity  of  sulphur  dioxide 
in  a  short  time,  but  it  is  far  more  expensive  than  burning  sulphur  by  the  pot 
method,  the  relative  cost  being  about  10  to  1.  The  method  of  using  liquid  sulphur 
dioxide,  however,  is  very  simple  and  it  is  free  from  any  danger  of  fire.  The  liquid  is 
prepared  commercially  and  is  usually  obtained  in  metal  cans  or  casks,  which  for  use 
only  require  the  simultaneous  cutting  of  the  leaden  pipes  on  the  tops  of  the  necessary 


34  INTERSTATE    QUARANTINE    REGULATIONS. 

number  of  cans  and  the  inversion  of  the  latter  in  a  metal  or  earthen  vessel,  when  vola- 
tilization rapidly  takes  place. 

To  obtain  the  5  per  cent  of  sulphur  dioxide  required  for  disinfection  it  is  necessary 
to  use  10  pounds  of  liquid  sulphur  dioxide  for  every  1,000  cubic  feet  of  air  space. 
Therefore  the  space  should  be  estimated  and  the  required  quantity  of  liquid  dioxide 
obtained.  Of  course,  with  this  method  the  same  preparations  and  precautions  with 
regard  to  injury  of  certain  articles  should  be  carried  out  as  with  the  pot  method. 
If  a  number  of  adjoining  rooms  are  to  be  disinfected  it  is  best  to  begin  opening  and 
inverting  the  cans  in  the  most  distant  rooms  and  work  toward  the  door  of  exit.  It  is 
necessary  to  have  everything  in  readiness  and  to  work  quickly,  as  the  gas  is  given 
off  rapidly.  If  the  container  of  the  liquid  dioxide  is  provided  with  a  siphon  or  tube, 
the  liquid  can  be  introduced  by  means  of  a  tube  through  the  keyhole  into  a  suitable 
receptacle  inside  the  room.    The  time  of  exposure  should  be  12  hours. 

One  striking  disadvantage  of  this  method  as  compared  with  the  pot  method  is  that 
it  produces  no  moisture,  which  is  necessary  to  obtain  the  maximum  disinfecting 
power  of  sulphur  dioxide. 

SULPHUR   CANDLES. 

As  sulphur  candles  are  applicable  only  for  killing  insects  and  not  for  disinfection 
purposes,  the  method  of  using  them  will  be  described  under  sulphur  as  an  insecticide. 

CHEMICAL  SOLUTIONS. 

BICHLORIDE    OP   MERCURY. 

This  substance  is  also  known  as  corrosive  sublimate,  bichloride,  and  mercuric  chlo- 
ride. In  the  pure  state  it  is  a  white  crystalline  substance  and  fairly  soluble  in 
water,  thus  differing  from  calomel  (mercurous  chloride),  which  is  a  white  amorphous 
powder  and  insoluble  in  water. 

The  "antiseptic  tablets"  sold  on  the  market  are  usually  composed  of  bichloride  of 
mercury.  These  tablets  are  generally  artificially  colored  (blue)  in  order  to  lessen 
the  chances  of  accidental  poisoning,  as  bichloride  of  mercury  dissolved  in  water 
makes  a  perfectly  clear  solution. 

Bichloride  of  mercury  is  one  of  the  most  powerful  germicides  that  we  possess.  It 
has  the  disadvantages,  however,  of  corroding  metals,  forming  inert  compounds  with 
albuminous  matter  and  of  being  very  poisonous.  It  is  therefore  inadvisable  to  use  it 
for  disinfecting  sputum,  excreta,  or  under  any  condition  in  which  it  comes  in  contact 
with  much  albuminous  or  organic  matter!  since  it  forms  inert  compounds  with  these 
substances. 

One  part  of  bichloride  of  mercury  will  dissolve  in  16  parts  of  cold  water  and  in  3 
parts  of  boiling  water.  The  bichloride  should  be  pulverized  before  attempting  to 
dissolve  it.  Even  then  it  dissolves  with  some  difficulty.  The  solubility  is  increased 
by  using  sea  water  for  the  solution  or  by  adding  2  parts  per  1,000  of  sodium  chloride 
(common  salt)  to  the  water  employed.  The  water  used  should  be  free  from  organic 
matter,  and  for  dissolving  the  bichloride  it  is  preferable  that  the  water  be  hot. 

The  strength  of  solution  used  in  disinfecting  for  the  infectious  diseases  is  usually 
1  part  of  bichloride  to  1,000  parts  of  water— i.  e. ,  a  strength  of  1  to  1,000.  This  solution 
is  made  by  dissolving  1  ounce  of  bichloride  in  1,000  ounces  of  water  (approximately 
8  gallons).  A  1  to  500  solution  is  made  by  dissolving  1  ounce  in  500  ounces  of  water, 
and  so  on  for  any  other  strength  desired.  The  solutions  are  best  made  in  an  earthen 
or  wooden  vessel,  a  wash  tub  or  barrel  being  very  suitable.  The  addition  of  a  little 
indigo  or  other  coloring  matter  will  avoid  the  possibility  of  the  solution  being  drunk 
by  mistake. 

To  disinfect  soiled  clothing,  bed  linen,  etc.,  the  material  should  be  placed  in  a  tub 
containing  1  to  1,000  solution  and  left  for  an  hour.     It  can  then  safely  be  taken  out 


APPENDIX.  35 

and  rinsed  in  water  and  laundered.  Bichloride  of  mercury,  however,  is  a  mordant, 
and  clothing  containing  stains,  such  as  blood,  etc.,  will  be  permanently  stained  if 
immersed  in  bichloride  solution.  Eating  utensils  should  not  be  placed  in  bichloride 
of  mercury  on  account  of  the  danger  from  poisoning.  Infected  floors,  tables,  wooden 
beds,  chairs,  walls,  etc.,  can  be  washed  with  a  1  to  1,000  solution  of  bichloride  of 
mercury.  For  applying  it  a  floor  mop  may  be  used.  Saturate  the  floors  and  other 
surfaces  with  the  solution  and  allow  them  to  dry.  The  hands  and  body,  except  the 
face,  can  be  bathed  in  a  1  to  1,000  solution  without  injury  thereto. 

As  already  stated,  feces,  urine,  sputum,  and  products  containing  albuminous  matter 
should  not  be  disinfected  with  bichloride  solution  unless  no  other  disinfectant  is 
available,  in  which  case  a  1  to  500  solution  should  be  used. 

"Antiseptic  tablets"  are  usually  very  soluble  in  water,  and  the  method  of  obtaining 
the  desired  strengths  is  stated  on  the  label  of  the  container.  They  are  very  useful 
when  only  a  small  quantity  of  bichloride  solution  is  required.  A  1  to  1,000  solution 
is  easily  prepared  from  them  and  is  of  service  for  washing  the  hands  after  handling 
the  sick  or  any  possibly  infected  material.  The  hands  should  be  bathed  in  the  solu- 
tion for  two  to  five  minutes  after  cleansing  them  with  soap  and  water. 

FORMALIN    (SOLUTION   OF  FORMALDEHYDE,    U.    S.    P.). 

Formalin,  a  solution  of  formaldehyde  gas  in  water,  is  a  valuable  disinfectant.  It 
has  the  advantage  of  bichloride  of  mercury  in  that  its  action  is  not  retarded  by 
albuminous  matter.  It  is  not  corrosive;  articles  are  usually  not  injured  by  it.  It 
is  a  good  deodorant,  and  it  is  not  so  highly  poisonous  as  is  bichloride  of  mercury. 

Formalin  contains  from  35  to  40  per  cent  of  formaldehyde  gas,  but  in  referring  to 
percentage  strengths  the  percentage  of  formalin  will  be  stated  and  not  that  of  the 
gas.  For  instance,  a  1  per  cent  solution  of  formalin  contains  formalin  in  the  propor- 
tion of  1  to  100,  but  it  contains  formaldehyde  gas  only  in  the  proportion  of  1  to  250, 
provided  the  formalin  contains  40  per  cent  formaldehyde  gas.  Therefore,  to  make 
a  5  per  cent  solution  of  formalin,  1  volume  of  formalin  is  added  to  19  volumes  of  water; 
and  to  make  a  10  per  cent  solution,  1  volume  of  formalin  is  added  to  9  volumes  of 
water,  etc. 

Formalin  is  well  adapted  to  the  disinfection  of  urine,  feces,  sputum,  and  discharges 
of  like  character;  for,  in  addition  to  disinfecting,  it  also  deodorizes  them.  For  this 
purpose  a  5  per  cent  solution  and  one  hour's  exposure  are  required.  The  substances 
should  he  thoroughly  mixed.  Allowance  must  be  made  for  the  dilution  caused 
by  mixing  the  formalin  solution  with  the  material  to  be  disinfected.  For  instance, 
if  1  pint  of  feces  is  to  be  disinfected  it  should  be  mixed  with  1  pint  of  a  10  per  cent 
solution  of  formalin,  which  gives  the  5  per  cent  strength  required. 

Formalin  can  not  be  used  in  the  sick  room,  as  the  liberated  gas  is  irritating;  nor 
is  it  adapted  to  the  washing  of  floors,  walls,  etc.,  for  the  same  reason. 

Soiled  linen  and  bedclothing  can  be  disinfected  by  one  hour's  immersion  in  a  5 
per  cent  solution  of  formalin. 

Disinfection  with  formalin  should  be  done  out  of  doors,  in  order  to  avoid  the  irri- 
tating effects  of  the  gas  given  off. 

A  few  drops  either  of  pure  or  diluted  formalin  poured  into  water  closet  bowls,  urinals, 
sinks,  etc.,  destroy  offensive  odors. 

CARBOLIC  ACID. 

This  is  a  very  useful  disinfectant.  It  has  a  penetrating  odor,  a  strong,  burning 
taste,  and  it  is  a  corrosive  poison.  Pure  carbolic  acid  crystallizes  and  becomes  solid 
at  ordinary  temperatures,  but  it  can  be  liquefied  either  by  heat  or  by  the  addition  of 
a  small  quantity  of  water,  about  5  per  cent. 


36  INTERSTATE    QUARANTINE    REGULATIONS. 

Carbolic  acid  is  soluble  in  about  15  parts  of  cold  water;  that  is,  1  ounce  of  carbolic 
acid  dissolves  in  1  pint  of  water  (16  ounces),  which  is  about  a  6  per  cent  solution. 

Carbolic  acid  dissolves  in  water  with  some  difficulty.  Therefore,  to  insure  its 
solubility,  hot  water  should  be  used  and  the  mixture  well  agitated. 

For  disinfection  purposes  carbolic  acid  is  commonly  used  in  solutions  of  3  to  5  per 
cent.  A  3  per  cent  solution  is  made  by  adding  3  volumes  of  carbolic  acid  to  97  volumes 
of  water;  a  5  per  cent  solution  is  made  by  adding  5  volumes  to  95  volumes  of  water,  etc. 

In  these  strengths  carbolic  acid  is  not  destructive  to  fabrics,  colors,  metals,  etc. 
Therefore,  it  has  a  wide  range  of  usefulness  in  disinfection.  As  it  does  not  actively 
coagulate  albuminous  matter,  it  is  useful  for  the  disinfection  of  urine,  feces,  sputum, 
etc.  For  this  purpose  a  5  per  cent  solution  is  added  to  an  equal  volume  of  the  excre- 
tions, the  mass  then  thoroughly  mixed,  and  allowed  to  stand  one  hour  before  final 
disposal. 

Soiled  linen,  bedclothes,  etc.,  are  best  disinfected  by  immersion  for  one  hour  in  a 
3  per  cent  solution,  and  the  same  strength  solution  should  be  used  for  mopping  floors, 
walls,  etc.  After  handling  the  sick  or  any  objects  possibly  infected,  such  as  bed- 
pans, sputum  cups,  etc.,  the  hands  may  be  disinfected  by  washing  them  for  two  to 
five  minutes  in  a  2\  per  cent  (1  to  40)  solution  of  carbolic  acid.  The  hands  should 
then  be  washed  or  saturated  with  alcohol  in  order  to  avoid  the  benumbing  effect  of 
the  carbolic  acid.  As  carbolic  acid  does  not  kill  spores,  it  should  not  be  used  to 
destroy  the  infection  of  tetanus,  anthrax,  or  malignant  oedema. 

Crude  carbolic  acid,  as  sold  upon  the  market,  is  a  black,  tarry  liquid  of  veiy  varying 
composition.  It  contains  cresols  and  other  compounds,  but  although  some  of  these 
products  have  greater  germicidal  powers  than  pure  phenol  (carbolic  acid)  their  solu- 
bility in  water  is  so  slight  that  the  use  of  crude  carbolic  acid  as  a  disinfectant  is  greatly 
limited.  The  reliability  of  crude  carbolic  acid  is  therefore  questionable,  and  some 
sanitarians  recommend  that  for  excreta  it  be  used  in  the  proportion  of  not  less  than 
two  volumes  of  crude  carbolic  acid  (undiluted  with  water)  to  each  volume  of  excreta. 

Crude  carbolic  acid  has  a  disagreeable  odor,  and  leaves  after  use  a  tarry  residue, 
which  is  objectionable.  The  crude  article,  however,  is  much  cheaper  than  pure  car- 
bolic acid,  and  it  is  hoped  that  a  simple  means  of  increasing  its  solubility  and  of 
eliminating  the  objectionable  tarry  residue  following  its  use  may  soon  be  found,  so 
that  it  may  at  least  be  employed  in  the  disinfection  of  urine,  feces,  sputum,  etc. 

TRICRESOL. 

Tricresol  has  practically  the  same  uses  in  disinfection  as  pure  carbolic  acid.  It 
differs  from  phenol  principally  in  that  it-1,  is  about  three  times  as  strong  in  germicidal 
powers.  It  therefore  can  be  depended  upon  to  kill  spores.  Tricresol  is  soluble  in 
water  up  to  about  2\  per  cent  solution — that  is,  1  part  of  tricresol  to  40  parts  of  water. 
A  1  to  2  per  cent  solution  used  under  the  same  conditions  and  for  the  same  purposes 
as  already  stated  for  carbolic  acid  is  efficient  for  all  ordinary  purposes. 

LYSOL  AND   CREOLIN. 

These  preparations  have  practically  the  same  uses  in  disinfection  as  carbolic  acid 
and  tricresol  and  belong  to  the  same  general  class  of  disinfectants. 

In  germicidal  strength  they  rank  with  tricresol.  Their  uses  are  the  same  as  tri- 
cresol and  carbolic  acid,  which  have  been  stated.  They  should  be  employed  in  a  1 
to  2  per  cent  solution. 

AGENTS  FOR  THE  DESTRUCTION  OF  VERMIN. 

The  destruction  of  vermin  and  disinfection  are  often  accomplished  simultaneously 
in  the  process  of  disinfection,  as  most  germicides  are  also  destructive  to  vermin,  a 
notable  exception  to  this  being  formaldehyde  gas,  -which,  although  a  good  germicide, 


APPENDIX.        .  37 

has  little  or  no  effect  upon  animal  life.  Therefore,  in  using  gaseous  germicides  (dis- 
infectants) as  insecticides,  they  are  applied  in  much  the  same  manner  when  used  for 
the  latter  as  for  the  former  purpose. 

However,  when  using  them  for  the  destruction  of  animal  lif  e  only  they  are  ordinarily 
applied  in  a  weaker  strength  and  for  a  shorter  time  of  exposure  than  when  they  are 
used  for  their  germicidal  effect. 

In  using  gaseous  insecticides,  every  care  should  be  exercised  to  avoid  the  escape  of 
the  vermin  from  the  inclosure  during  the  process  of  killing;  consequently  all  points 
of  exit  should  be  closed.  Closets,  bookcases,  drawers,  etc.,  likely  to  harbor  or  contain 
animal  life,  should  be  opened  to  allow  access  of  the  gas. 

The  following  insecticides  will  be  considered: 

1.  Sulphur. 

2.  Hydrocyanic  acid  gas. 

3.  Pyrethrum. 

SULPHUR. 

Sulphur  is  one  of  the  most  valuable  and  efficient  insecticides  that  we  possess.  It 
may  be  used  in  several  forms. 

Sulphur  dioxide. — The  methods  of  producing  this  gas  have  already  been  described, 
therefore  further  description  here  will  consist  only  of  the  differences  between  its  uses 
tind  applications  as  an  insecticide  and  those  as  a  germicide. 

As  an  insecticide  sulphur  does  not  require  the  presence  of  moisture,  since  it  acts 
equally  well  in  a  diy  as  in  a  moist  atmosphere.  Therefore  moisture  should  not  be 
artificially  produced,  as  the  drier  the  atmosphere  the  less  injury  there  will  be  to 
furnishings,  colors,  etc. 

With  all  cracks  and  crevices  closed  to  prevent  their  exit,  a  1  per  cent  strength  will 
kill  flies  and  mosquitoes  within  two  hours,  and  if  the  atmosphere  is  reasonably  dry 
very  little  injury  will  be  done  to  the  ordinary  room  furnishings. 

A  2  per  cent  strength  will  kill  rats  within  four  hours,  and  a  5  per  cent  strength  will 
destroy  most  bedbugs,  roaches,  lice,  etc.,  within  six  hours,  although  some  of  these 
insects  usually  escape  by  seeking  protection  in  crevices.  To  obtain  the  desired 
strength  of  sulphur  gas  it  is  only  necessary  to  remember  that  the  burning  of  1  pound  of 
sulphur  in  1,000  cubic  feet  of  space  produces  approximately  1  per  cent  of  the  gas,  2 
pounds,  2  per  cent,  etc. 

The  pot  method  of  production  has  already  been  described.  In  order  to  burn  the  sul- 
phur quickly  it  should  not  be  placed  in  the  pots  to  a  greater  depth  than  an  inch. 
Water  pans  are  not  required,  but  the  pots  should  be  placed  upon  bricks,  sand,  stones, 
or  something  of  that  nature  as  a  protection  against  fire.  The  pots  are  arranged  and 
lighted  with  alcohol,  as  has  been  described. 

Liquid  sulphur  dioxide  is  well  adapted  to  the  destruction  of  insect  and  vermin  life, 
as  the  gas  is  liberated  in  a  short  time.  Two  pounds  of  the  liquid  are  equivalent  to  1 
pound  of  sulphur  when  burnt  by  the  pot  method.  •  The  method  of  liberating  the  gas 
has  been  described. 

Sulphur  candles  are  sometimes  useful  for  killing  flies  and  mosquitoes,  or  where  only  a 
small  percentage  of  the  gas  is  required.  Candles  vary  in  weight,  but  their  weight 
should  be  determined;  for  killing  flies  and  mosquitoes  not  less  than  1£  pounds  of 
candle  should  be  used  for  each  1,000  cubic  feet.  The  candles  require  only  to  be 
placed  upon  bricks  and  lighted ;  they  usually  burn  easily.  The  usual  time  of  exposure 
(two  hours)  13  required. 

HYDROCYANIC    ACID   GAS. 

This  gas  is  very  poisonous  to  all  forms  of  animal  life.  It  kills  rats,  mice,  roaches, 
flies,  fleas,  mosquitoes,  and  bedbugs  with  great  certainty  and  very  quickly.  In  the 
hands  of  the  inexperienced  it  is  a  very  dangerous  gas,  as  the  least  carelessness  with  it  may 


38  INTERSTATE    QUARANTINE    REGULATIONS. 

result  in  the  loss  of  human  life,  since  it  is  deadly  poisonous.     It  is  therefore  unsafe  and 

unwise  to  use  in  inhabited  buildings,  but  it  is  useful  for  destroying  all  forms  of  vermin 

in  cars,  granaries,  stables,  barns,  poultry  houses,  and  other  uninhabited  buildings. 

For  this  purpose  it  is  used  in  the  following  quantities  and  proportions  for  each  1,000 

cubic  feet  of  air  space : 

Ounces. 

Potassium  cyanide 5 

Sulphuric  acid  (commercial  66B) 5 

Water 12.  5 

The  acid  and  water  are  first  mixed  in  an  earthen  vessel  that  will  withstand  heat,  as 
this  mixture  gets  very  hot .  The  cyanide  should  not  be  added  to  it  until  the  liquid  has 
become  cool.  The  required  quantity  of  cyanide  should  be  weighed  and  put  into  a 
gauze  bag,  and  when  everything  is  in  readiness  the  bag  is  placed  in  the  liquid  con- 
tained in  the  vessel.  The  acid  destroys  the  bag  and  acts  on  the  cyanide  with  rapid 
evolution  of  the  gas;  and  as  the  gas  is  deadly  poisonous,  the  operator  must  leave  the 
room  at  once. 

A  still  safer  method  of  adding  the  cyanide  to  the  acid  than  the  one  just  stated  is  to 
have  the  bag  of  cyanide  suspended  over  the  acid  by  means  of  a  string  leading  to  the 
door  of  exit,  from  which  location  it  can  be  lowered  into  the  acid  when  desired.  In 
this  manner  one  or  more  processes  can  be  set  off  without  danger  to  the  operator. 

The  inclosure  should  be  made  as  tight  as  possible  to  avoid  the  escape  of  the  gas. 
The  time  of  exposure  should  be  one  hour,  though  a  longer  period  will  minimize  the 
danger  from  the  gas  in  opening  the  doors  and  windows.  It  should  be  arranged  before 
starting  the  process,  so  that  the  windows  and  doors  can  be  opened  from  the  outside; 
and  it  is  best  to  hold  the  breath  while  actually  opening  a  door  or  window.  Under 
no  condition  should  the  building  be  entered  until  it  has  been  aired  out  from  8  to  10 
hours. 

PYRETHRUM. 

Pyrethrum  is  only  a  fairly  good  insecticide.  It  Is  not  poisonous  to  man,  nor  are 
household  furnishings  of  any  kind  injured  by  it.  Unfortunately,  it  is  not  very  powerful 
for  the  destruction  of  roaches,  flies,  fleas,  and  mosquitoes.  Some  of  these  insects  are 
killed,  while  some  are  only  stupefied,  by  pyrethrum,  so  that  it  is  necessary  after  using 
it  to  sweep  the  insects  up  and  bum  them. 

Pyrethrum  maybe  used  either  in  powdered  form  or  as  fumes  resulting  from  burning. 
Persian  and  other  insect  powders  sold  upon  the  market  usually  contain  pyrethrum 
in  some  form.  As  a  powder  it  may  be  blown  about  in  the  closed  room  with  a  bellows 
in  sufficient  quantity  to  show  perceptibly  upon  the  floor,  or  it  may  be  dusted  into 
cracks,  crevices,  dark  comers,  closets,  or  special  localities  likely  to  be  infested  with 
mosquitoes,  fleas,  bedbugs,  etc.  After  two  hours'  exposure  the  insects  should,  when 
practicable,  be  swept  up  and  burned. 

In  burning  pyrethrum  for  killing  flies  and  mosquitoes  the  room  should  be  closed 
as  tightly  as  possible.  In  killing  these  insects  in  dwellings  it  is  well  to  pull  down 
all  window  shades  except  one,  as  the  insects  will  then  go  toward  the  fight  of  the 
window  the  shade  of  which  is  not  drawn,  and  when  they  die  or  become  stupefied  they 
can  be  easily  swept  up.     Pasting  of  door  and  window  cracks  is  usually  unnecessary. 

From  2  to  4  pounds  of  pyrethrum  should  be  burned  for  every  1,000  cubic  feet. 
The  pyrethrum  is  burned  in  pots,  pans,  or  iron  buckets  in  the  same  manner  that 
sulphur  is'burned  in  the  pot  method.  The  pots  should  be  used  in  sufficient  numbers 
so  that  not  more  than  4  pounds  of  pyrethrum  will  have  to  be  placed  in  each  pot. 
They  should  be  distributed  about  in  the  room  upon  metal  or  stone  foundations,  in 
order  to  guard  against  fire. 

The  pyrethrum  is  ignited  by  sprinkling  it  with  alcohol  and  lighting.  After 
the  alcohol  has  burnt,   the  pyrethrum  smolders  and  bums,   thus  liberating  the 


APPENDIX.  39 

fumes.  The  time  of  exposure  is  usually  two  hours,  although  when  working  at  night 
the  quarters  may  be  left  closed  until  the  following  morning.  As  stated,  the  insects 
should  be  swept  up  and  burned  as  soon  as  the  quarters  are  opened.  Both  the  fumes 
and  the  powdered  form  of  pyrethrum  are  harmless  to  man,  so  there  is  no  danger  in 
entering  quarters  as  soon  as  they  are  opened. 

DISINFECTION  OF  COMPARTMENTS. 

Compartments  or  places  in  cars,  vessels,  vehicles,  or  conveyances  operated  in  inter- 
state traffic,  which  have  been  occupied  by  persons  sick  with  contagious  or  infectious 
diseases,  shall,  unless  otherwise  specified  in  the  special  regulations,  be  disinfected 
prior  to  further  use  as  follows: 

The  compartment  or  place,  and  all  articles  therein  contained,  shall  be  exposed  to 
the  action  of  formaldehyde  gas,  using  1  pint  of  a  formaldehyde  solution  (U.  S.  P.)  for 
each  1,000  cubic  feet  of  space,  the  gas  to  be  generated  by  one  of  the  methods  hereto- 
fore described,  and  the  compartment  or  place  so  closed  or  sealed  as  to  prevent  the 
escape  or  leakage  of  gas. 

The  minimum  number  of  hours'  exposure  as  given  above  applies  to  empty  rooms  of 
tight  construction  containing  smooth,  hard,  surfaces;  the  maximum  number  of  hours' 
exposure  applying  in  all  cases  to  textiles  and  other  articles  of  a  similar  kind  requiring 
more  or  less  penetration. 

The  stated  time  of  exposure  to  sulphur  dioxide  and  formaldehyde  is  sufficient  to 
destroy  bacterial  infection  due  to  non-spore-bearing  organisms,  provided  the  infection 
is  present  on  the  surface.  If  the  room  is  of  peculiar  construction,  so  as  to  impede  the 
diffusion  of  the  gas,  or  if  the  room  is  a  dirty  one,  or  if  on  account  of  any  other  condition 
rendering  the  germicidal  action  of  the  gas  more  difficult,  the  time  of  exposure  should 
be  proportionately  increased,  or  supplanted  by  other  methods. 

After  gaseous  disinfection,  all  bedclothes,  towels,  and  similar  articles  shall  be 
immersed  for  at  least  one  hour  in  a  5  per  cent  solution  of  carbolic  acid  or  formaldehyde, 
or  disinfected  by  boiling  or  by  steam.  Mattresses,  curtains,  carpets,  hangings,  pillows, 
or  other  textile  articles  shall  be  burned  or  disinfected  by  steam.  The  floor,  walls,  and 
all  other  objects  that  will  not  be  injured  by  liquids  shall  be  mechanically  cleaned 
and  thoroughly  wetted  with  a  5  per  cent  solution  of  carbolic  acid  or  formaldehyde. 

Textiles  which  are  soiled  with  the  discharges  of  the  sick,  or  presumably  are  infected, 
must  be  disinfected  by  (a)  boiling;  (6)  steam;  (c)  immersion  in  one  of  the  germicidal 
solutions. 

Cooking  and  eating  utensils  are  preferably  disinfected  by  immersion  in  boiling 
water  or  by  steam,  but  where  these  are  not  available  immersion  in  a  5  per  cent  carbolic- 
acid  solution  for  at  least  one  hour,  followed  by  thorough  washing  and  rinsing,  shall 
be  practiced. 

Clothing,  fabrics,  textiles,  curtains,  hangings,  etc.,  may  be  treated  by  either  of 
the  above  methods,  from  (a)  to  (c),  inclusive,  as  circumstances  may  demand,  or  by 
formaldehyde  gas  or  sulphur  dioxide  where  the  article  is  of  a  character  which  will  not 
be  damaged  by  sulphur  dioxide. 

Living  apartments,  cabins,  and  forecastles  of  vessels  shall  be  disinfected  by  one  or 
more  of  the  following  methods: 

(a)  Sulphur  dioxide,  the  destructive  action  of  the  gas  on  property  being  borne  in 
mind. 

(6)  Formaldehyde  gas. 

(c)  Washing  with  solution  of  bichloride  of  mercury,  1:1000,  or  5  per  cent  solution  of 
formaldehyde,  or  5  per  cent  solution  of  carbolic  acid,  preference  being  given  to  carbolic 
acid  for  application  to  polished  woods,  bright  metals,  and  other  objects  injured  by 
metallic  salts. 

The  forecastle,  steerage,  and  other  living  apartments  in  bad  sanitary  condition  must 
be  disinfected  by  method  (a)  followed  b}'  method  (c). 


40  INTERSTATE    QUARANTINE    REGULATIONS. 

Mattresses,  pillows,  and  heavy  fabrics  are  to  be  disinfected  by  one  of  the  following 
methods: 

(a)  Boiling. 

(b)  Flowing  steam  (i.  e.,  steam  not  under  pressure). 

(c)  Steam  under  pressure. 

(d)  Steam  in  a  special  apparatus  with  vacuum  attachment. 

Holds  of  cargo  vessels,  when  cargo  can  not  be  removed,  shall  be  disinfected  in  so 
far  as  possible  by  sulphur  dioxide  not  less  than  4  per  cent  volume  strength,  and  where 
possible  this  should  be  generated  from  a  furnace  to  minimize  danger  of  fire  in  cargo. 

Holds  of  iron  vessels,  empty,  shall  be  disinfected  by  either  of  the  following  methods: 

(a)  Sulphur  dioxide  generated  by  burning  sulphur,  5  pounds  per  1.000  cubic  feet 
of  air  space,  or  liberated  from  10  pounds  of  liquid  sulphur  dioxide,  sufficient  moisture 
being  present  in  both  cases.     Time  of  exposure  24  hours. 

(b)  Washing  with  a  solution  of  bichloride  of  mercury,  1: 1000. 

BACTERIOLOGICAL  STANDARD  OF  PURITY  FOR  DRINKING  WATER 
SUPPLIED  TO  THE  PUBLIC  BY  COMMON  CARRIERS  IN  INTERSTATE 
COMMERCE. 

[Promulgated  by  the  Secretary  of  the  Treasury  on  Oct.  21, 1914.] 

The  following  are  the  maximum  limits  of  permissible  bacteriological  impurity: 

1.  The  total  number  of  bacteria  developing  on  standard  agar  plates,  incubated  24 
hours  at  37°  C,  shall  not  exceed  100  per  cubic  centimeter;  provided  that  the  estimate 
shall  be  made  from  not  less  than  two  plates,  showing  such  numbers  and  distribution 
of  colonies  as  to  indicate  that  the  estimate  is  reliable  and  accurate. 

2.  Not  more  than  one  out  of  five  10  c.  c.  portions  of  any  sample  examined  shall  show 
the  presence  of  organisms  of  the  Bacillus  coli  group  when  tested  as  follows: 

(a)  Five  10  c.  c.  portions  of  each  sample  tested  shall  be  planted,  each  in  a  fermenta- 
tion tube  containing  not  less  than  30c.  c.  of  lactose  peptone  broth.  These  shall  be  incu- 
bated 48  hours  at  37°  C.  and  observed  to  note  gas  formation. 

(b)  From  each  tube  showing  gas  more  than  5  per  cent  of  the  closed  arm  of  fermenta- 
tion tube,  plates  shall"  be  made  after  48  hours'  incubation  upon  lactose  litmus  agar 
or  Endo's  medium. 

(c)  When  plate  colonies  resembling  B.  coli  develop  upon  either  of  these  plate  media 
within  24  hours,  a  well-isolated  characteristic  colony  shall  be  fished  and  transplanted 
into  a  lactose-broth  fermentation  tube,  which  shall  be  incubated  at  37°  C.  for  48 
hours.  * 

For  the  purposes  of  enforcing  any  regulations  which  may  be  based  upon  these  rec- 
ommendations the  following  may  be  considered  sufficient  evidence  of  the  presence  of 
organisms  of  the  Bacillus  coli  group: 

Formation  of  gas  in  fermentation  tube  containing  original  sample  of  water  (a). 

Development  of  acid-forming  colonies  on  lactose  litmus  agar  plates  or  bright  red 
colonies  on  Endo's  medium  plates,  when  plates  are  prepared  as  directed  above 
under  (b). 

The  formation  of  gas,  occupying  10  per  cent  or  more  of  closed  arm  of  fermentation 
tube,  in  lactose  peptone  broth  fermentation  tube  inoculated  with  colony  fished  from 
24-hour  lactose  litmus  agar  or  Endo's  medium  plate. 

These  steps  are  selected  with  reference  to  demonstrating  the  presence  in  the  samples 
examined  of  aerobic  lactose-fermenting  organisms. 

3.  It  is  recommended  as  a  routine  procedure,  that  in  addition  to  five  10  c.  c.  portions 
one  1  c.  c.  portion  and  one  0.1  c.  c,  portion  of  each  sample  examined  be  planted  in  a 
lactose  peptone  broth  fermentation  tube,  in  order  to  demonstrate  more  fully  the  extent 
of  pollution  in  grossly  polluted  samples. 


APPENDIX.  41 

4.  It  is  recommended  that  in  the  above-designated  tests  the  culture  media  and 
methods  used  shall  be  in  accordance  with  the  specifications  of  the  committee  on 
standard  methods  of  water  analysis  of  the  American  Public  Health  Association,  as 
set  forth  in  "Standard  Methods  of  Water  Analysis"  (A.  P.  H.  A.,  1912). 

[Form  8921.] 

Treasury  Department,  United  States  Public  Health  Service. 

CERTIFICATE    OF   EXAMINATION    OF   WATER    FOR    PASSENGERS  IN 
INTERSTATE  TRAFFIC. 

This  is  to  certify  that  the  water  supplied 

at ,  for  use  of  passengers  in  inter- 
state traffic  has  been  examined  and  found to  conform  to  the  bacteriological 

standard  promulgated  by  the  Secretary  of  the  Treasury  on  October  21,  1914. 

Date  of  examination 

(Signature  of  health  authority) 

(Official  title  of  health  authority) 

Address 


INSTRUCTIONS  RELATIVE  TO  THE  CERTIFICATION  OF  WATER  FUR- 
NISHED TO  PASSENGERS  IN  INTERSTATE  TRAFFIC. 

Samples  of  water  from  each  and  every  source  of  supply  should  be  subjected  to 
bacteriological  examination  at  least  once  in  every  six  months  by  the  United  States 
interstate  sanitary  officer  or  the  State  or  municipal  health  authority  within  whose 
jurisdiction  the  supply  is  obtained,  or  by  any  person  competent  to  make  such  exam- 
inations, and  whose  results  will  be  accepted  by  the  State  or  municipal  health  authority 
whose  duty  it  is  to  issue  certificates. 

Officers  of  the  United  States  Public  Health  Service  are  authorized  to  make  bacte- 
riological and  chemical  examinations,  and  to  certify  to  the  purity,  of  water  furnished 
to  passengers  in  interstate  traffic. 

The  common  carrier  desiring  a  certificate  should  make  application  therefor  to  the 
State  or  municipal  health  authority  within  whose  jurisdiction  the  water  is  obtained, 
or  to  the  United  States  interstate  sanitary  officer  of  the  district  in  which  the  water 
is  obtained. 

After  the  necessary  examinations  have  been  made,  the  certificate  should  be  issued 
on  Form  8921,  "Certificate  of  Examination  of  Water  for  Passengers  in  Interstate 
Traffic,"  in  triplicate.  The  certifying  authority  should  retain  one  copy  of  the  cer- 
tificate and  deliver  two  copies  to  the  common  carrier,  who  should  forward  one  copy 
to  the  Surgeon  General,  United  States  Public  Health  Service,  Washington,  D.  C. 

Whenever  there  is  an  unusual  prevalence  of  typhoid  fever,  dysentery,  infantile 
diarrhea,  or  other  water-borne  disease  in  a  locality  from  which  common  carriers 
receive  water,  an  additional  examination  of  the  water  should  be  made  and  a  supple- 
mental certificate  issued  by  the  proper  certifying  authority  and  forwarded  as  above. 

Certificates  of  examination  of  ice  are  not  required. 

o 


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